Fast, portable test can diagnose COVID-19 and track variants



IMAGE: The NIRVANA field-test package
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Credit score: Mo Li/KAUST

LA JOLLA–(March 31, 2021) Clinicians utilizing a brand new viral screening take a look at can’t solely diagnose COVID-19 in a matter of minutes with a transportable, pocket-sized machine, however may also concurrently take a look at for different viruses–like influenza–that is likely to be mistaken for the coronavirus. On the identical time, they will sequence the virus, offering priceless data on the unfold of COVID-19 mutations and variants. The brand new take a look at, dubbed NIRVANA, was described on-line as we speak by a multi-institution crew of scientists within the journal Med.

“It is a virus detection and surveillance technique that does not require an costly infrastructure like different approaches,” says Juan Carlos Izpisua Belmonte, co-corresponding creator and a professor in Salk’s Gene Expression Laboratory. “We will accomplish with one moveable take a look at the identical factor that others are utilizing two or three totally different checks, with totally different machines, to do.”

All over the world, greater than 100 million individuals have been contaminated with SARS-CoV-2, the virus that causes COVID-19. A staggering 500,000 Individuals have died from COVID-19 up to now. Testing the inhabitants is essential to stopping the unfold of the virus. As well as, monitoring the unfold of latest SARS-CoV-2 variants–some of which may reply in a different way to therapies or vaccines–is essential.

At present, the usual strategy to figuring out whether or not a nasal swab is constructive for COVID-19 is to run a polymerase chain response (PCR) take a look at to detect genetic materials from the SARS-CoV-2 virus. If the pattern is damaging, nonetheless, sufferers and clinicians do not get any data on what is likely to be inflicting the coronavirus-like symptoms–unless they run separate PCR checks, utilizing totally different swab samples, for different viruses. And if the pattern is constructive for SARS-CoV-2, they do not be taught which COVID-19 variant a affected person is contaminated with until one other set of checks is run; these require a big and costly next-generation gene-sequencing machine.

Final summer season, Mo Li, an assistant professor of bioscience at King Abdullah College of Science and Know-how in Saudi Arabia, was pondering methods he may lend his experience in genetic engineering and nanopore sequencing to combatting the COVID-19 pandemic. Li, who beforehand spent six years as a Salk postdoctoral researcher within the Izpisua Belmonte lab, puzzled whether or not a gene-detection strategy known as isothermal recombinase polymerase amplification (RPA) coupled with real-time nanopore sequencing is likely to be extra useful–and quicker, cheaper and extra portable–than the present COVID-19 testing strategy. He teamed up with Izpisua Belmonte to seek out out.

Not like PCR, which cycles via decrease and better temperatures to separate DNA strands and replica them, RPA makes use of proteins–rather than temperature changes–to accomplish the identical factor in solely 20 minutes. The expertise lets researchers copy longer stretches of DNA, and probe for a number of genes on the identical time.

“We rapidly realized that we may use this method to not solely detect SARS-CoV-2, however different viruses on the identical time,” says Li.

Within the new paper, Li and Izpisua Belmonte describe a small, moveable system that may display 96 samples on the identical time utilizing the RPA assay. They name the strategy NIRVANA, for “nanopore sequencing of isothermal fast viral amplification for close to real-time evaluation.”

The scientists designed NIRVANA to concurrently take a look at samples for COVID-19, influenza A, human adenovirus, and non-SARS-CoV-2 human coronavirus. In simply 15 minutes, the researchers report, the system begins to report constructive and damaging outcomes. And inside three hours, the system finalizes outcomes on all 96 samples–including the sequences of 5 areas of SARS-CoV-2 which might be significantly susceptible to accumulate mutations resulting in new variants such because the B.1.1.7 variant recognized within the UK.

Li and Izpisua Belmonte examined NIRVANA on 10 samples identified to be constructive for SARS-CoV-2, 60 samples of unknown SARS-CoV-2 standing, in addition to samples of municipal wastewater harboring the SARS-COV-2 virus and others. In all instances, the assay was capable of accurately establish which viruses have been current. The sequencing knowledge additionally allowed them to slender down the origin of SARS-CoV-2 in constructive samples; differentiating strains from China and Europe, as an example.

“The design of this assay is absolutely versatile, so it is not simply restricted to the examples we have proven,” says Li. “We will simply adapt it to sort out one other pathogen, even one thing new and emergent.”

With the small measurement and portability of the NIRVANA workflow, it could possibly be used for quick virus detection at faculties, airports or ports, the researchers say. It additionally could possibly be used to observe wastewater or streams for the presence of latest viruses.

“The pandemic has supplied two essential classes: first, take a look at extensively and rapidly, and second, know your variants. Our NIRVANA technique offers a promising answer to those two challenges not just for the present pandemic but in addition for attainable future ones,” says Izpisua Belmonte, who holds the Roger Guillemin Chair at Salk. Market evaluation can be required to find out whether or not the preliminary price of commercialization–and the fixed tweaks to the take a look at wanted to ensure it detected new variants or new viruses of interest–are value it, Belmonte provides.


Along with Izpisua Belmonte and Li, different authors on the examine have been Concepcion Rodriguez Esteban of Salk; Chongwei Bi, Gerargo Ramos-Mandujano, Sharis Hala, Jinna Xu, Sara Mfarrej, Yeteng Tian and Arnab Ache of King Abdullah College of Science and Know-how (KAUST); Estrella Nunez Delicado of UCAM Universidad Católica San Antonio de Murcia; Fadwa Alofi of King Fahad Hospital; Asim Khogeer of Saudi Arabia’s Ministry of Well being; Anwar Hashem of King Abdulaziz College; and Naif Almontashiri of Taibah College.

The work described within the present paper was supported by a aggressive analysis grant from the King Abdullah College of Science and Know-how.

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