1
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Vásquez V, Orozco J. Clinical validation of SARS-CoV-2 electrochemical immunosensor based on the spike-ACE2 complex. J Virol Methods 2024; 327:114940. [PMID: 38608761 DOI: 10.1016/j.jviromet.2024.114940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND AND AIMS Advances in health, especially in prevention, diagnosis, and treatment, have significantly impacted the way of facing emerging infectious diseases. Yet, events such as the COVID-19 pandemic have shown that there is still a long way to go. Therefore, an urgent need exists for portable and easily deployable point-of-care (POC) detection tools. Biosensors at the POC remain in the laboratory in an analytical characterization step and are not yet mature enough to reach the market massively. In this context, it is necessary to progress in validating these devices to demonstrate their relevance in detecting different disease biomarkers. This work reports on the clinical validation of an electrochemical immunosensor for detecting SARS-CoV-2. METHODS A monocentric retrospective cohort study was conducted with 150 random nasopharyngeal swabs or tracheal aspiration samples tested by RT-PCR. The immunosensor based on magnetic beads and chronoamperometry detected SARS-CoV-2 through the spike-angiotensin-converting protein (ACE2) immunocomplex. RESULTS This biosensor demonstrated 96.04 % clinical sensitivity and 87.75 % clinical specificity in detecting SARS-CoV-2 in the samples, highly correlated with the RT-PCR gold standard. CONCLUSIONS It demonstrates the potential of electrochemical biosensors to be implemented as highly sensitive and easily deployable detection strategies even in remote locations.
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Affiliation(s)
- Viviana Vásquez
- Max Planck Tandem Group in Nanobioengineering. Institute of Chemistry, Faculty of Natural and Exact Sciences, University of Antioquia, Complejo Ruta N, Calle 67 Nº 52-20, Medellín 050010, Colombia
| | - Jahir Orozco
- Max Planck Tandem Group in Nanobioengineering. Institute of Chemistry, Faculty of Natural and Exact Sciences, University of Antioquia, Complejo Ruta N, Calle 67 Nº 52-20, Medellín 050010, Colombia.
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2
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Chen H, Zhuang Z, Xu N, Feng Y, Fang K, Tan C, Tan Y. Simple, Visual, Point-of-Care SARS-CoV-2 Detection Incorporating Recombinase Polymerase Amplification and Target DNA-Protein Crosslinking Enhanced Chemiluminescence. BIOSENSORS 2024; 14:135. [PMID: 38534242 DOI: 10.3390/bios14030135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 03/28/2024]
Abstract
The ongoing COVID-19 pandemic, driven by persistent SARS-CoV-2 transmission, threatens human health worldwide, underscoring the urgent need for an efficient, low-cost, rapid SARS-CoV-2 detection method. Herein, we developed a point-of-care SARS-CoV-2 detection method incorporating recombinase polymerase amplification (RPA) and DNA-protein crosslinking chemiluminescence (DPCL) (RPADPCL). RPADPCL involves the crosslinking of biotinylated double-stranded RPA DNA products with horseradish peroxidase (HRP)-labeled streptavidin (SA-HRP). Modified products are captured using SA-labeled magnetic beads, and then analyzed using a chemiluminescence detector and smartphone after the addition of a chemiluminescent substrate. Under optimal conditions, the RPADPCL limit of detection (LOD) was observed to be 6 copies (within the linear detection range of 1-300 copies) for a plasmid containing the SARS-CoV-2 N gene and 15 copies (within the linear range of 10-500 copies) for in vitro transcribed (IVT) SARS-CoV-2 RNA. The proposed method is convenient, specific, visually intuitive, easy to use, and does not require external excitation. The effective RPADPCL detection of SARS-CoV-2 in complex matrix systems was verified by testing simulated clinical samples containing 10% human saliva or a virus transfer medium (VTM) spiked with a plasmid containing a SARS-CoV-2 N gene sequence or SARS-CoV-2 IVT RNA. Consequently, this method has great potential for detecting targets in clinical samples.
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Affiliation(s)
- Hui Chen
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Department of Chemistry, Tsinghua University, Beijing 100084, China
| | - Zhiyuan Zhuang
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Naihan Xu
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- School of Food and Drug, Shenzhen Polytechnic University, Shenzhen 518055, China
| | - Ying Feng
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Kaixin Fang
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Chunyan Tan
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Department of Chemistry, Tsinghua University, Beijing 100084, China
| | - Ying Tan
- State Key Laboratory of Chemical Oncogenomics, Institute of Biomedical and Health Engineering, Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Department of Chemistry, Tsinghua University, Beijing 100084, China
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3
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Li D, Sun C, Zhuang P, Mei X. Revolutionizing SARS-CoV-2 omicron variant detection: Towards faster and more reliable methods. Talanta 2024; 266:124937. [PMID: 37481886 DOI: 10.1016/j.talanta.2023.124937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/03/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
The emergence of the highly contagious Omicron variant of SARS-CoV-2 has inflicted significant damage during the ongoing COVID-19 pandemic. This new variant's significant sequence changes and mutations in both proteins and RNA have rendered many existing rapid detection methods ineffective in identifying it accurately. As the world races to control the spread of the virus, researchers are urgently exploring new diagnostic strategies to specifically detect Omicron variants with high accuracy and sensitivity. In response to this challenge, we have compiled a comprehensive overview of the latest reported rapid detection techniques. These techniques include strategies for the simultaneous detection of multiple SARS-CoV-2 variants and methods for selectively distinguishing Omicron variants. By categorizing these diagnostic techniques based on their targets, which encompass protein antigens and nucleic acids, we aim to offer a comprehensive understanding of the utilization of various recognition elements in identifying these targets. We also highlight the advantages and limitations of each approach. Our work is crucial in providing a more nuanced understanding of the challenges and opportunities in detecting Omicron variants and emerging variants.
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Affiliation(s)
- Dan Li
- College of Pharmacy, Jinzhou Medical University, Jinzhou, 121000, China.
| | - Cai Sun
- AECC Shenyang Liming Aero-Engine Co., Ltd., Shenyang, China
| | - Pengfei Zhuang
- College of Pharmacy, Jinzhou Medical University, Jinzhou, 121000, China
| | - Xifan Mei
- Key Laboratory of Medical Tissue Engineering of Liaoning Province, Jinzhou Medical University, Jinzhou, Liaoning, China.
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4
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Shrestha K, Kim S, Han J, Florez GM, Truong H, Hoang T, Parajuli S, AM T, Kim B, Jung Y, Abafogi AT, Lee Y, Song SH, Lee J, Park S, Kang M, Huh HJ, Cho G, Lee LP. Mobile Efficient Diagnostics of Infectious Diseases via On-Chip RT-qPCR: MEDIC-PCR. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2302072. [PMID: 37587764 PMCID: PMC10558658 DOI: 10.1002/advs.202302072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/21/2023] [Indexed: 08/18/2023]
Abstract
The COVID-19 outbreak has caused public and global health crises. However, the lack of on-site fast, reliable, sensitive, and low-cost reverse transcription polymerase chain reaction (RT-PCR) testing limits early detection, timely isolation, and epidemic prevention and control. Here, the authors report a rapid mobile efficient diagnostics of infectious diseases via on-chip -RT-quantitative PCR (RT-qPCR): MEDIC-PCR. First, the authors use a roll-to-roll printing process to accomplish low-cost carbon-black-based disposable PCR chips that enable rapid LED-induced photothermal PCR cycles. The MEDIC-PCR can perform RT (3 min), and PCR (9 min) steps. Further, the cohort of 89 COVID-19 and 103 non-COVID-19 patients testing is completed by the MEDIC-PCR to show excellent diagnostic accuracy of 97%, sensitivity of 94%, and specificity of 98%. This MEDIC-PCR can contribute to the preventive global health in the face of a future pandemic.
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Affiliation(s)
- Kiran Shrestha
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
| | - Seongryeong Kim
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
| | - Jiyeon Han
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
| | - Gabriela Morales Florez
- Department of Biological ScienceCollege of ScienceSungkyunkwan UniversitySuwon16419South Korea
| | - Han Truong
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
| | - Trung Hoang
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
| | - Sajjan Parajuli
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
| | - Tiara AM
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Research Engineering Center for R2R Printed Flexible ComputerSungkyunkwan UniversitySuwon16419South Korea
| | - Beomsoo Kim
- School of Electronic and Electrical EngineeringSungkyunkwan UniversitySuwon16419South Korea
| | - Younsu Jung
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Research Engineering Center for R2R Printed Flexible ComputerSungkyunkwan UniversitySuwon16419South Korea
| | | | - Yugyeong Lee
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwon16419South Korea
| | - Seung Hyun Song
- Department of Electronics EngineeringSookmyung Women's UniversitySeoul04310South Korea
| | - Jinkee Lee
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- School of Mechanical EngineeringSungkyunkwan UniversitySuwon16419South Korea
| | - Sungsu Park
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- School of Mechanical EngineeringSungkyunkwan UniversitySuwon16419South Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwon16419South Korea
| | - Minhee Kang
- Biomedical Engineering Research CenterSmart Healthcare Research InstituteSamsung Medical CenterSeoul06352South Korea
- Department of Medical Device Management and ResearchSAIHST (Samsung Advanced Institute for Health Sciences & Technology)Sungkyunkwan UniversitySeoul06355South Korea
| | - Hee Jae Huh
- School of MedicineDepartment of Laboratory Medicine and GeneticsSamsung Medical CenterSungkyunkwan UniversitySeoul06351South Korea
| | - Gyoujin Cho
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Research Engineering Center for R2R Printed Flexible ComputerSungkyunkwan UniversitySuwon16419South Korea
| | - Luke P. Lee
- Department of BiophysicsInstitute of Quantum BiologySungkyunkwan UniversitySuwon16419South Korea
- Harvard Medical SchoolDepartment of MedicineBrigham Women's HospitalBostonMA02115USA
- Department of BioengineeringUniversity of California at BerkeleyBerkeleyCA94720USA
- Department of Electrical Engineering and Computer ScienceUniversity of California at BerkeleyBerkeleyCA94720USA
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5
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Li T, Chen Y, Chen Z, Hao Y, Liang M, Liu Y, Ou G, Zhang H, Tang Y, Hao Y, Wageh S, Al-Hartomy OA, Kalam A, Zhang B, Shi X, Li X, Zhang H. Early and Sensitive Detection of Pathogens for Public Health and Biosafety: An Example of Surveillance and Genotyping of SARS-CoV-2 in Sewage Water by Cas12a-Facilitated Portable Plasmonic Biosensor. RESEARCH (WASHINGTON, D.C.) 2023; 6:0205. [PMID: 37521328 PMCID: PMC10380551 DOI: 10.34133/research.0205] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]
Abstract
Infectious diseases severely threaten public health and global biosafety. In addition to transmission through the air, pathogenic microorganisms have also been detected in environmental liquid samples, such as sewage water. Conventional biochemical detection methodologies are time-consuming and cost-ineffective, and their detection limits hinder early diagnosis. In the present study, ultrafine plasmonic fiber probes with a diameter of 125 μm are fabricated for clustered regularly interspaced short palindromic repeats/CRISPR-associated protein (CRISPR/Cas)-12a-mediated sensing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Single-stranded DNA exposed on the fiber surface is trans-cleaved by the Cas12a enzyme to release gold nanoparticles that are immobilized onto the fiber surface, causing a sharp reduction in the surface plasmon resonance (SPR) wavelength. The proposed fiber probe is virus-specific with the limit of detection of ~2,300 copies/ml, and genomic copy numbers can be reflected as shifts in wavelengths. A total of 21 sewage water samples have been examined, and the data obtained are consistent with those of quantitative polymerase chain reaction (qPCR). In addition, the Omicron variant and its mutation sites have been fast detected using S gene-specific Cas12a. This study provides an accurate and convenient approach for the real-time surveillance of microbial contamination in sewage water.
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Affiliation(s)
- Tianzhong Li
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
| | - Yuzhi Chen
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Sensor Technology, Shenzhen 518060, China
| | - Zhi Chen
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan People's Hospital, Qingyuan 511518, China
| | - Yuan Hao
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Sensor Technology, Shenzhen 518060, China
| | - Minyi Liang
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Sensor Technology, Shenzhen 518060, China
| | - Yingxia Liu
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital,
Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen 518112, China
| | - Guanyong Ou
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital,
Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen 518112, China
- School of Medicine,
Southern University of Science and Technology, Shenzhen 518055, China
| | - Huanian Zhang
- School of Physics and Optoelectronic Engineering,
Shandong University of Technology, Zibo 255049, China
| | - Yuxuan Tang
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
| | - Yabing Hao
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
| | - Swelm Wageh
- Department of Physics, Faculty of Science,
King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Omar A. Al-Hartomy
- Department of Physics, Faculty of Science,
King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Abul Kalam
- Research Center for Advanced Materials Science (RCAMS),
King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia
- Department of Chemistry,
College of Science, King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia
| | - Bin Zhang
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
| | - Xin Shi
- Health Sciences Institute,
China Medical University, Shenyang 110000, China
| | - Xuejin Li
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
- Shenzhen Key Laboratory of Sensor Technology, Shenzhen 518060, China
- The Chinese University of Hong Kong, Shenzhen 518060, China
| | - Han Zhang
- College of Physics and Optoelectronic Engineering, Institute of Translational Medicine, Department of Otolaryngology, Shenzhen Second People’s Hospital,
First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen University, Shenzhen 518060, China
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6
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Huang W, Zhang Z, Lin D, Deng Y, Chen X, Huang J. RT-nestRPA is a new technology for the rapid and sensitive detection of nucleic acid detection of pathogens used for a variety of medical application scenarios. Anal Chim Acta 2023; 1262:341263. [PMID: 37179064 PMCID: PMC10123537 DOI: 10.1016/j.aca.2023.341263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/18/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The effective detection of pathogens is of great importance for the diagnosis and treatment of infectious diseases. We have proposed the novel RT-nestRPA technique for SARS-CoV-2 detection, which is a rapid RNA detection technique with ultra-high sensitivity. RESULTS The RT-nestRPA technology has a sensitivity of 0.5 copies/uL of synthetic RNA targeting the ORF7a/7b/8 gene or 1 copy/uL synthetic RNA targeting the N gene of SARS-CoV-2. The entire detection process of RT-nestRPA only takes only 20 min, which is significantly shorter than RT-qPCR (nearly 100 min). Additionally, RT-nestRPA is capable of detecting dual genes of SARS-CoV-2 and human RPP30 simultaneously in one reaction tube. The excellent specificity of RT-nestRPA was verified by analyzing twenty-two SARS-CoV-2 unrelated pathogens. Furthermore, RT-nestRPA had great performance in detecting samples treated with cell lysis buffer without RNA extraction. The innovative double-layer reaction tube for RT-nestRPA can prevent aerosol contamination and simplify the reaction operation. Moreover, the ROC analysis revealed that RT-nestRPA had high diagnostic value (AUC = 0.98), while the AUC of RT-qPCR was 0.75. SIGNIFICANCE Our current findings suggested that RT-nestRPA could serve as a novel technology for nucleic acid detection of pathogens with rapid and ultrahigh sensitive features used in various medical application scenarios.
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Affiliation(s)
- Wanqiu Huang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Centre for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Zhaoqi Zhang
- Department of General Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China
| | - Dachuan Lin
- Guangdong Key Laboratory of Regional Immunity and Diseases, Department of Pathology Biology, School of Medicine, Shenzhen University, Shenzhen, 518060, China
| | - Yuliang Deng
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Centre for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xinchun Chen
- Guangdong Key Laboratory of Regional Immunity and Diseases, Department of Pathology Biology, School of Medicine, Shenzhen University, Shenzhen, 518060, China
| | - Jian Huang
- Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Centre for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, 200240, China.
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7
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Malaga JL, Pajuelo MJ, Okamoto M, Tsinda EK, Otani K, Tsukayama P, Mascaro L, Cuicapuza D, Katsumi M, Kawamura K, Nishimura H, Sakagami A, Ueki Y, Omiya S, Okamoto S, Nakayama A, Fujimaki SI, Yu C, Azam S, Kodama E, Dapat C, Oshitani H, Saito M. Rapid Detection of SARS-CoV-2 RNA Using Reverse Transcription Recombinase Polymerase Amplification (RT-RPA) with Lateral Flow for N-Protein Gene and Variant-Specific Deletion-Insertion Mutation in S-Protein Gene. Viruses 2023; 15:1254. [PMID: 37376555 DOI: 10.3390/v15061254] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/21/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Rapid molecular testing for severe acute respiratory coronavirus 2 (SARS-CoV-2) variants may contribute to the development of public health measures, particularly in resource-limited areas. Reverse transcription recombinase polymerase amplification using a lateral flow assay (RT-RPA-LF) allows rapid RNA detection without thermal cyclers. In this study, we developed two assays to detect SARS-CoV-2 nucleocapsid (N) gene and Omicron BA.1 spike (S) gene-specific deletion-insertion mutations (del211/ins214). Both tests had a detection limit of 10 copies/µL in vitro and the detection time was approximately 35 min from incubation to detection. The sensitivities of SARS-CoV-2 (N) RT-RPA-LF by viral load categories were 100% for clinical samples with high (>9015.7 copies/µL, cycle quantification (Cq): < 25) and moderate (385.5-9015.7 copies/µL, Cq: 25-29.9) viral load, 83.3% for low (16.5-385.5 copies/µL, Cq: 30-34.9), and 14.3% for very low (<16.5 copies/µL, Cq: 35-40). The sensitivities of the Omicron BA.1 (S) RT-RPA-LF were 94.9%, 78%, 23.8%, and 0%, respectively, and the specificity against non-BA.1 SARS-CoV-2-positive samples was 96%. The assays seemed more sensitive than rapid antigen detection in moderate viral load samples. Although implementation in resource-limited settings requires additional improvements, deletion-insertion mutations were successfully detected by the RT-RPA-LF technique.
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Affiliation(s)
- Jose L Malaga
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Monica J Pajuelo
- Laboratorio Microbiología Molecular, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Michiko Okamoto
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Emmanuel Kagning Tsinda
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
- Center for Biomedical Innovation, Sinskey Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Kanako Otani
- National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Pablo Tsukayama
- Laboratorio de Genómica Microbiana, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Lucero Mascaro
- Laboratorio Microbiología Molecular, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Diego Cuicapuza
- Laboratorio de Genómica Microbiana, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Masamichi Katsumi
- Sendai City Institute of Health, Sendai 984-0002, Japan
- Sendai Shirayuri Women's College, Sendai 981-3107, Japan
| | | | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Sendai 983-8520, Japan
| | - Akie Sakagami
- Department of Microbiology, Miyagi Prefectural Institute of Public Health and Environment, Sendai 983-0836, Japan
| | - Yo Ueki
- Department of Microbiology, Miyagi Prefectural Institute of Public Health and Environment, Sendai 983-0836, Japan
| | - Suguru Omiya
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Sendai 983-8520, Japan
| | - Satoshi Okamoto
- Department of Clinical Laboratory, Tohoku Kosai Hospital, Sendai 980-0803, Japan
| | - Asami Nakayama
- Department of Laboratory Medicine, Tohoku University Hospital, Sendai 980-8574, Japan
| | - Shin-Ichi Fujimaki
- Department of Laboratory Medicine, Tohoku University Hospital, Sendai 980-8574, Japan
| | - Chuyao Yu
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Sikandar Azam
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Eiichi Kodama
- International Research Institute of Disaster Science, Tohoku University, Sendai 980-8572, Japan
| | - Clyde Dapat
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
- WHO Collaborating Centre for Reference and Research on Influenza, The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC 3000, Australia
| | - Hitoshi Oshitani
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Mayuko Saito
- Department of Virology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
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8
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Yu B, Xu C, Huang S, Ni J, Zhou J, Zhang Y, Wu M, Zhang J, Fang L. Development of a universal real-time RT-PCR assay for detection of pan-SARS-coronaviruses with an RNA-based internal control. Front Microbiol 2023; 14:1181097. [PMID: 37275136 PMCID: PMC10232947 DOI: 10.3389/fmicb.2023.1181097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/13/2023] [Indexed: 06/07/2023] Open
Abstract
The current pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exemplifies the critical need for rapid diagnostic assays to prompt intensified virological monitoring both in human and wild animal populations. To date, there are no clinical validated assays for pan-SARS-coronavirus (pan-SARS-CoV) detection. Here, we suggest an innovative primer design strategy for the diagnosis of pan-SARS-CoVs targeting the envelope (E) gene using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Furthermore, we developed a new primer-probe set targeting human β2-microglobulin (B2M) as an RNA-based internal control for process efficacy. The universal RT-qPCR assay demonstrated no false-positive amplifications with other human coronaviruses or 20 common respiratory viruses, and its limit of detection (LOD) was 159.16 copies/ml at 95% detection probability. In clinical validation, the assay delivered 100% sensitive results in the detection of SARS-CoV-2-positive oropharyngeal samples (n = 120), including three variants of concern (Wuhan, Delta, and Omicron). Taken together, this universal RT-qPCR assay provides a highly sensitive, robust, and rapid detection of SARS-CoV-1, SARS-CoV-2, and animal-derived SARS-related CoVs.
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Affiliation(s)
- Beibei Yu
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Changping Xu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shiwang Huang
- Shangcheng District Center for Disease Control and Prevention, Hangzhou, China
| | - Jun Ni
- Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Jiancang Zhou
- Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
| | - Yuting Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Maomao Wu
- Wenzhou Center for Disease Control and Prevention, Wenzhou, China
| | - Jun Zhang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Lei Fang
- Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou, China
- Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, China
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9
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Zhang Y, Clarke SP, Wu H, Li W, Zhou C, Lin K, Wang J, Wang J, Liang Y, Wang X, Wang L. A comprehensive overview on the transmission, pathogenesis, diagnosis, treatment, and prevention of SARS-CoV-2. J Med Virol 2023; 95:e28776. [PMID: 37212261 DOI: 10.1002/jmv.28776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/17/2023] [Accepted: 04/24/2023] [Indexed: 05/23/2023]
Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV) is a single positive-strand RNA virus that is responsible for the current pandemic that the world has been facing since 2019. The primary route of transmission of SARS-CoV-2 is through respiratory tract transmission. However, other transmission routes such as fecal-oral, vertical transmission, and aerosol-eye also exist. In addition, it has been found that the pathogenesis of this virus involves the binding of the virus's S protein to its host cell surface receptor angiotensin-converting enzyme 2, which results in the subsequent membrane fusion that is required for SARS-CoV-2 to replicate and complete its entire life. The clinical symptoms of patients infected with SARS-CoV-2 can range from asymptomatic to severe. The most common symptoms seen include fever, dry cough, and fatigue. Once these symptoms are observed, a nucleic acid test is done using reverse transcription-polymerase chain reaction. This currently serves as the main confirmatory tool for COVID-19. Despite the fact that no cure has been found for SARS-CoV-2, prevention methods such as vaccines, specific facial mask, and social distancing have proven to be quite effective. It is imperative to have a complete understanding of the transmission and pathogenesis of this virus. To effectively develop new drugs as well as diagnostic tools, more knowledge about this virus would be needed.
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Affiliation(s)
- Yiting Zhang
- The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Key Laboratory of Zoonoses of High Institutions in Anhui, Department of Microbiology and Parasitology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | | | - Huanwu Wu
- The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Key Laboratory of Zoonoses of High Institutions in Anhui, Department of Microbiology and Parasitology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Wenli Li
- The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Key Laboratory of Zoonoses of High Institutions in Anhui, Department of Microbiology and Parasitology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Chang Zhou
- The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Key Laboratory of Zoonoses of High Institutions in Anhui, Department of Microbiology and Parasitology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Kang Lin
- Department of Basic Medical Sciences, Morphological Experimental Center, Anhui Medical University, Hefei, Anhui, China
| | - Jiawen Wang
- Department of Pharmacy, Anhui Medical University, Hefei, Anhui, China
| | - Jinzhi Wang
- Department of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
| | - Ying Liang
- Department of The Second Clinical School of Medicine, Anhui Medical University, Hefei, Anhui, China
| | - Xin Wang
- Department of Chemistry, Anhui Medical University, Hefei, Anhui, China
| | - Linding Wang
- The Key Laboratory of Microbiology and Parasitology of Anhui Province, The Key Laboratory of Zoonoses of High Institutions in Anhui, Department of Microbiology and Parasitology, School of Basic Medical Sciences, Anhui Medical University, Hefei, Anhui, China
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10
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Rasheed MK, Awrahman HA, Amin Al‐Jaf SM, Niranji SS. Identification of SARS CoV‐2 Omicron BA.1 and a novel Delta lineage by rapid methods and partial spike protein sequences in Sulaymaniyah Province, Iraq. Immun Inflamm Dis 2023; 11:e801. [PMID: 36988244 PMCID: PMC10022420 DOI: 10.1002/iid3.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/22/2022] [Accepted: 02/09/2023] [Indexed: 03/19/2023] Open
Abstract
Background Five variants of concern (VOCs) of severe acute respiratory syndrome coronavirus 2 (SARS CoV‐2) have been globally recorded including Alpha, Beta, Gamma, Delta, and Omicron. The Omicron variant has outcompeted the other variants including the Delta variant. Molecular screenings of VOCs are important for surveillance, treatment, and vaccination programs. This study aimed to identify VOCs by using rapid inexpensive methods and partial sequencing of the virus's spike gene. Methods Mutation‐specific rRT PCR probes were used for both D614G and K417N mutations to potentially discriminate between Delta and Omicron variants. These were followed by sequencing of a fragment of spike gene (748 nucleotides), which covers the most notable VOC mutations in the receptor binding domain of SARS CoV‐2. Results Rapid methods showed that out of 24 SARS CoV‐2 positive samples, 19 carried the N417 mutation, which is present in the Omicron variant. Furthermore, 3 samples carried K417 wildtype, which is present in the Delta variant. Additionally, 2 samples containing both K417 and N417 suggested mixed infections between the two variants. The D614G mutation was present in all samples. Among the 4 samples sequenced, 3 samples carried 13 mutations, which are present in Omicron BA.1. The fourth sample contained the two common mutations (T478K and L452R) present in Delta, in addition to two more rare mutations (F456L and F490S), which are not commonly seen in Delta. Our data suggested that both Omicron variant BA.1 and a novel Delta variant might have circulated in this region that needs further investigations.
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Affiliation(s)
- Mariwan Kadir Rasheed
- College of Health ScienceUniversity of Human DevelopmentSulaymaniyahIraq,Sulaimani Veterinary DirectorateSulaimaniIraq
| | - Harem Abdalla Awrahman
- Hiwa Hospital, Sulaymaniyah General Directory of HealthMinistry of HealthSulaymaniyahIraq
| | - Sirwan M. Amin Al‐Jaf
- College of MedicineUniversity of GarmianKalarIraq,Coronavirus Research and Identification LabUniversity of GarmianKalarIraq
| | - Sherko S. Niranji
- College of MedicineUniversity of GarmianKalarIraq,Coronavirus Research and Identification LabUniversity of GarmianKalarIraq
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11
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Shan Y, Wang B, Huang H, Yan K, Li W, Wang S, Liu F. Portable high-throughput multimodal immunoassay platform for rapid on-site COVID-19 diagnostics. Anal Chim Acta 2023; 1238:340634. [PMID: 36464448 PMCID: PMC9671405 DOI: 10.1016/j.aca.2022.340634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/21/2022] [Accepted: 11/15/2022] [Indexed: 11/17/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a causal agent of Coronavirus Disease 2019 (COVID-19) has led to the global pandemic. Though the real-time reverse transcription polymerase chain reaction (RT-PCR) acting as a gold-standard method has been widely used for COVID-19 diagnostics, it can hardly support rapid on-site applications or monitor the stage of disease development as well as to identify the infection and immune status of rehabilitation patients. To suit rapid on-site COVID-19 diagnostics under various application scenarios with an all-in-one device and simple detection reagents, we propose a high-throughput multimodal immunoassay platform with fluorescent, colorimetric, and chemiluminescent immunoassays on the same portable device and a multimodal reporter probe using quantum dot (QD) microspheres modified with horseradish peroxidase (HRP) coupled with goat anti-human IgG. The recombinant nucleocapsid protein fixed on a 96-well plate works as the capture probe. In the condition with the target under detection, both reporter and capture probes can be bound by such target. When illuminated by excitation light, fluorescence signals from QD microspheres can be collected for target quantification often at a fast speed. Additionally, when pursuing simple detection without using any sensing devices, HRP-catalyzed TMB colorimetric immunoassay is employed; and when pursuing highly sensitive detection, HRP-catalyzed luminol chemiluminescent immunoassay is established. Verified by the anti-SARS-CoV-2 N humanized antibody, the sensitivities of colorimetric, fluorescent, and chemiluminescent immunoassays are respectively 20, 80, and 640 times more sensitive than that of the lateral flow colloidal gold immunoassay strip. Additionally, such a platform can simultaneously detect multiple samples at the same time thus supporting high-throughput sensing; and all these detecting operations can be implemented on-site within 50 min relying on field-operable processing and field-portable devices. Such a high-throughput multimodal immunoassay platform can provide a new all-in-one solution for rapid on-site diagnostics of COVID-19 for different detecting purposes.
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Affiliation(s)
- Yanke Shan
- Joint International Research Laboratory of Animal Health and Food Safety of Ministry of Education & Single Molecule Nanometry Laboratory (Sinmolab), Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Bin Wang
- Joint International Research Laboratory of Animal Health and Food Safety of Ministry of Education & Single Molecule Nanometry Laboratory (Sinmolab), Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China
| | - Huachuan Huang
- School of Manufacture Science and Engineering, Key Laboratory of Testing Technology for Manufacturing Process, Ministry of Education, Southwest University of Science and Technology, Mianyang, Sichuan, 621010, China
| | - Keding Yan
- Advanced Institute of Micro-Nano Intelligent Sensing (AIMNIS), School of Electronic Information Engineering, Xi'an Technological University, Xi'an, Shaanxi, 710032, China
| | - Wenzhi Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710000, China.
| | - Shouyu Wang
- Joint International Research Laboratory of Animal Health and Food Safety of Ministry of Education & Single Molecule Nanometry Laboratory (Sinmolab), Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China; OptiX+ Laboratory, Wuxi, Jiangsu, China.
| | - Fei Liu
- Joint International Research Laboratory of Animal Health and Food Safety of Ministry of Education & Single Molecule Nanometry Laboratory (Sinmolab), Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China.
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12
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Akarapipad P, Bertelson E, Pessell A, Wang TH, Hsieh K. Emerging Multiplex Nucleic Acid Diagnostic Tests for Combating COVID-19. BIOSENSORS 2022; 12:bios12110978. [PMID: 36354487 PMCID: PMC9688249 DOI: 10.3390/bios12110978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 05/29/2023]
Abstract
The COVID-19 pandemic caused by SARS-CoV-2 has drawn attention to the need for fast and accurate diagnostic testing. Concerns from emerging SARS-CoV-2 variants and other circulating respiratory viral pathogens further underscore the importance of expanding diagnostic testing to multiplex detection, as single-plex diagnostic testing may fail to detect emerging variants and other viruses, while sequencing can be too slow and too expensive as a diagnostic tool. As a result, there have been significant advances in multiplex nucleic-acid-based virus diagnostic testing, creating a need for a timely review. This review first introduces frequent nucleic acid targets for multiplex virus diagnostic tests, then proceeds to a comprehensive and up-to-date overview of multiplex assays that incorporate various detection reactions and readout modalities. The performances, advantages, and disadvantages of these assays are discussed, followed by highlights of platforms that are amenable for point-of-care use. Finally, this review points out the remaining technical challenges and shares perspectives on future research and development. By examining the state of the art and synthesizing existing development in multiplex nucleic acid diagnostic tests, this review can provide a useful resource for facilitating future research and ultimately combating COVID-19.
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Affiliation(s)
- Patarajarin Akarapipad
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Elizabeth Bertelson
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Alexander Pessell
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Tza-Huei Wang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Kuangwen Hsieh
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
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13
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Jiang W, Ji W, Zhang Y, Xie Y, Chen S, Jin Y, Duan G. An Update on Detection Technologies for SARS-CoV-2 Variants of Concern. Viruses 2022; 14:v14112324. [PMID: 36366421 PMCID: PMC9693800 DOI: 10.3390/v14112324] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/15/2022] [Accepted: 10/20/2022] [Indexed: 01/18/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the global epidemic of Coronavirus Disease 2019 (COVID-19), with a significant impact on the global economy and human safety. Reverse transcription-quantitative polymerase chain reaction (RT-PCR) is the gold standard for detecting SARS-CoV-2, but because the virus's genome is prone to mutations, the effectiveness of vaccines and the sensitivity of detection methods are declining. Variants of concern (VOCs) include Alpha, Beta, Gamma, Delta, and Omicron, which are able to evade recognition by host immune mechanisms leading to increased transmissibility, morbidity, and mortality of COVID-19. A range of research has been reported on detection techniques for VOCs, which is beneficial to prevent the rapid spread of the epidemic, improve the effectiveness of public health and social measures, and reduce the harm to human health and safety. However, a meaningful translation of this that reduces the burden of disease, and delivers a clear and cohesive message to guide daily clinical practice, remains preliminary. Herein, we summarize the capabilities of various nucleic acid and protein-based detection methods developed for VOCs in identifying and differentiating current VOCs and compare the advantages and disadvantages of each method, providing a basis for the rapid detection of VOCs strains and their future variants and the adoption of corresponding preventive and control measures.
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Affiliation(s)
- Wenjie Jiang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Wangquan Ji
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Yu Zhang
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Yaqi Xie
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Shuaiyin Chen
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Henan Key Laboratory of Molecular Medicine, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: (S.C.); (Y.J.); (G.D.); Tel.: +86-13523408394 (S.C.); +86-0371-67781453 (Y.J.); +86-0371-67789797 (G.D.)
| | - Yuefei Jin
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: (S.C.); (Y.J.); (G.D.); Tel.: +86-13523408394 (S.C.); +86-0371-67781453 (Y.J.); +86-0371-67789797 (G.D.)
| | - Guangcai Duan
- Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
- Henan Key Laboratory of Molecular Medicine, Zhengzhou University, Zhengzhou 450001, China
- Correspondence: (S.C.); (Y.J.); (G.D.); Tel.: +86-13523408394 (S.C.); +86-0371-67781453 (Y.J.); +86-0371-67789797 (G.D.)
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