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Team develops method to identify future SARS-CoV-2 mutations that could affect rapid antigen test performance

Team develops method to identify future SARS-CoV-2 mutations that could affect rapid antigen test performance

A new study co-led by investigators from Brigham and Women’s Hospital has identified a method that may help to predict how future SARS-CoV-2 mutations could potentially impact the performance of rapid antigen tests – a type of test that is increasingly being used for point-of-care testing for COVID-19.

The findings, published in the journal Nature Medicine, could guide the development of more sophisticated rapid antigen tests and improve the effectiveness of these tests as a public health tool.

“As SARS-CoV-2 continues to spread and mutate, it’s crucial that we have accurate and up-to-date diagnostic tests to detect the virus,” said corresponding author Daniel Q. Richmond, PhD, of Brigham’s Department of Infectious Diseases and Global Health. “Our study provides a method for rapidly assessing how new viral variants might impact the performance of rapid antigen tests, which could be critical information for test developers as they work to keep up with the ever-changing landscape of this pandemic.”

Rapid antigen tests are small, portable devices that can provide results in as little as 15 minutes by testing a sample from a nasal swab for the presence of proteins from the SARS-CoV-2 virus. These tests are less accurate than laboratory-based PCR tests, but they are widely used because they are less expensive and can be administered with less training.

Recent studies have shown that some SARS-CoV-2 variants, including those first identified in the UK and South Africa, can cause false-negative results on rapid antigen tests. As the pandemic continues to evolve, there is a need for a way to rapidly assess how future mutations might affect test performance.

In this study, the researchers used a method called “error-prone PCR” to create artificial mutations in the SARS-CoV-2 genome. They then used these mutated viruses to infect human cells in the laboratory and tested the ability of four different rapid antigen tests to detect the presence of the virus.

The researchers found that the tests were able to detect the majority of variants with no significant loss in performance. However, they also identified a small number of variants that caused false-negative results on all of the tested rapid antigen tests.

“Our findings show that rapid antigen tests are generally quite robust in the face of viral mutations, but there is a possibility that future variants could emerge that could cause these tests to fail,” said first author Jesse Bloom, PhD, of the Fred Hutchinson Cancer Research Center. “It will be important to continue to monitor the effectiveness of these tests as the pandemic continues to evolve.”

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