A Direct Method for RT-PCR Detection of SARS-CoV-2 in Clinical Samples

Introduction: the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic of acute respiratory disease (COVID-19). SARS-CoV-2 is a positive-strand RNA virus and its genomic characterization has played a vital role in the design of appropriate diagnostics tests. The current RT-PCR protocol for SARS-CoV-2 detects two regions of the viral genome, requiring RNA extraction and several hours. There is a need for fast, simple, and cost-effective detection strategies. Methods: we optimized a protocol for direct RT-PCR detection of SARS-CoV-2 without the need for nucleic acid extraction. Nasopharyngeal samples were diluted to 1:3 using diethyl pyrocarbonate (DEPC)-treated water. The diluted samples were incubated at 95 °C for 5 min in a thermal cycler, followed by a cooling step at 4 °C for 5 min. Samples then underwent reverse transcription real-time RT-PCR in the E and RdRp genes. Results: our direct detection protocol showed 100% concordance with the standard protocol with an average Ct value difference of 4.38 for the E region and 3.85 for the RdRp region. Conclusion: the direct PCR technique was found to be a reliable and sensitive method that can be used to reduce the time and cost of the assay by removing the need for RNA extraction. It enables the use of the assay in research, diagnostics, and screening for COVID-19 in regions with fewer economic resources, where supplies are more limited allowing for wider use for screening.

[1]  A. Arroliga,et al.  Early trends for SARS‐CoV‐2 infection in central and north Texas and impact on other circulating respiratory viruses , 2020, medRxiv.

[2]  E. Yap,et al.  Rapid Direct Nucleic Acid Amplification Test without RNA Extraction for SARS-CoV-2 Using a Portable PCR Thermocycler , 2020, bioRxiv.

[3]  B. Reinius,et al.  Massive and rapid COVID-19 testing is feasible by extraction-free SARS-CoV-2 RT-PCR , 2020, Nature Communications.

[4]  R. González-Montelongo,et al.  Fast SARS-CoV-2 detection by RT-qPCR in preheated nasopharyngeal swab samples , 2020, International Journal of Infectious Diseases.

[5]  Scott Tighe,et al.  Direct RT-qPCR detection of SARS-CoV-2 RNA from patient nasopharyngeal swabs without an RNA extraction step , 2020, PLoS biology.

[6]  Kai Zhao,et al.  A pneumonia outbreak associated with a new coronavirus of probable bat origin , 2020, Nature.

[7]  Jing Zhao,et al.  Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia , 2020, The New England journal of medicine.

[8]  K. Kain,et al.  A Direct from Blood/Plasma Reverse Transcription-Polymerase Chain Reaction for Dengue Virus Detection in Point-of-Care Settings. , 2019, The American journal of tropical medicine and hygiene.

[9]  E. Starick,et al.  Sample preparation for avian and porcine influenza virus cDNA amplification simplified: Boiling vs. conventional RNA extraction. , 2015, Journal of virological methods.

[10]  H. Tonoike,et al.  Detection of noroviruses in fecal specimens by direct RT-PCR without RNA purification. , 2010, Journal of virological methods.

[11]  M. Abdel-hamid,et al.  Optimization, assessment, and proposed use of a direct nested reverse transcription-polymerase chain reaction protocol for the detection of hepatitis C virus. , 1997, Journal of human virology.

[12]  C. E. WHO Coronavirus Disease (COVID-19) Dashboard , 2020 .