Point-of-care testing for COVID-19: a simple two-step molecular diagnostic development and validation during the SARS-CoV-2 pandemic

Mem Inst Oswaldo Cruz. 2024 Oct 4:119:e230236. doi: 10.1590/0074-02760230236. eCollection 2024.

Abstract

Background: During the coronavirus disease 19 (COVID-19) pandemic, diagnostic testing of the general population proved challenging due to limitations of the gold-standard diagnostic procedure using reverse transcription real-time polymerase chain reaction (RT-qPCR) for large-scale testing on the centralised model, especially in low-resource areas.

Objectives: To address this, a point-of-care (PoC) diagnostic protocol for COVID-19 was developed, providing fast, reliable, and affordable testing, particularly for low-mid develop areas.

Methods: The PoC diagnostic process combines a simple paper-based RNA extraction method housed within a 3D-printed plastic device with a colorimetric reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay. Nasopharyngeal/oropharyngeal swabs (NOS) and saliva samples were tested between 2020 and 2021, with the assistance of Santa Catarina's State Health Secretary, Brazil.

Findings: The developed diagnostic protocol showed a limit of detection of 9,900 copies and an overall diagnostic specificity of 98% for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 1,348 clinical analysed samples. The diagnostic sensitivity was 95% for NOS samples, 85% for early morning saliva, and 69% for indiscriminate saliva.

Main conclusions: In conclusion, the developed device successfully extracted SARS-CoV-2 viral RNA from swabs and saliva clinical samples. When combined with colorimetric RT-LAMP, it provides results within 45 min using minimal resources, thus delivering a diagnostic kit protocol that is applicable in large-scale sampling.

Publication types

  • Validation Study

MeSH terms

  • Brazil
  • COVID-19 Nucleic Acid Testing / methods
  • COVID-19 Testing / methods
  • COVID-19* / diagnosis
  • Humans
  • Molecular Diagnostic Techniques* / methods
  • Nasopharynx / virology
  • Nucleic Acid Amplification Techniques* / methods
  • Pandemics
  • Point-of-Care Testing*
  • RNA, Viral / analysis
  • RNA, Viral / isolation & purification
  • Reproducibility of Results
  • SARS-CoV-2* / genetics
  • SARS-CoV-2* / isolation & purification
  • Saliva* / virology
  • Sensitivity and Specificity*

Substances

  • RNA, Viral

Supplementary concepts

  • LAMP assay

Grants and funding

FIOCRUZ (VPPIS-005-FIO-20-2-45 - to ANP as a member of the grant team), SPK Solutions / ENGIE / Ministério Público do Trabalho - SC (to ANP and LDPR), Welcome Trust (grant 207486/Z/17/Z - to LDPR as a member of the grant team), CNPq (to OBR).