PMC:7574920 / 27234-30181
Annnotations
LitCovid-PD-FMA-UBERON
{"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T122","span":{"begin":1579,"end":1582},"obj":"Body_part"}],"attributes":[{"id":"A122","pred":"fma_id","subj":"T122","obj":"http://purl.org/sig/ont/fma/fma67095"}],"text":"Testing clinical samples with the swab–to–RT-LAMP assay\nOn the basis of these preliminary experiments, we decided to use swab samples either directly without any treatment (direct swab–to–RT-LAMP assay) or after heat treatment for 5 min at 95°C (hot swab–to–RT-LAMP assay). As an additional precaution, we kept the samples in the cold (using an ice-cold metal block) whenever possible. For testing large numbers of clinical samples, we performed the RT-LAMP assay using several 96-well plates. In total, we tested 209 different samples using the hot swab–to–RT-LAMP assay, and of these, 131 samples also were tested by the direct swab–to–RT-LAMP assay. Many samples were tested twice but using aliquots withdrawn at different time points (usually within 24 hours) from the swab samples stored at 4°C. This resulted in 235 direct swab–to–RT-LAMP assay measurements and 343 hot swab–to–RT-LAMP assay measurements (Fig. 5A). The hot swab–to–RT-LAMP assay detected a color change in the majority of samples with a CT \u003c 30 with high sensitivity, whereas the direct swab–to–RT-LAMP assay only exhibited a high sensitivity for samples with a CT \u003c 25 (Fig. 5 and Table 3). The heat treatment rendered the RT-LAMP assay more stringent as it reduced false positives and more sensitive for samples with a CT of 25 to 30. We found that some positive samples did not induce a color change but did so when assayed a second time. We therefore would recommend running this assay using technical duplicates.\nFig. 5 Swab–to–RT-LAMP assay of clinical pharyngeal swab samples.\n(A) Skipping a prior RNA isolation step, pharyngeal swab samples were subjected to the RT-LAMP assay either directly (left) or after 5 min of heat treatment at 95°C (right). For each sample, scatter plots are used to compare the swab–to–RT-LAMP assay results (ΔOD values) with the results of RT-qPCR (CT values). The measurement time point was 30 min after the start of the 65°C incubation. (B) Shown is the sensitivity (right) and specificity (left) of the swab–to–RT-LAMP assay [derived from the data in (A)] using the decision threshold indicated by the horizontal gray line in (A). Specificity and sensitivity values (thick lines) are shown with their 95% confidence intervals (boxes) as in Fig. 3, with blue indicating the direct swab–to–RT-LAMP assay and red indicating the hot swab–to–RT-LAMP assay. (Also see table S3).\nTable 3 Shown is RT-qPCR and RT-LAMP testing of 592 clinical samples stratified into CT value bins (see Fig. 5A).\nFig. 5A and table S3 show specificity and sensitivity values calculated from these numbers.\nHot swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 38 4 42\n25–30 17 5 22\n30–35 5 23 28\n35–40 0 36 36\nNeg Neg 1 214 215\nSum 61 282 343\nDirect swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 15 1 16\n25–30 6 11 17\n30–35 2 21 23\n35–40 3 23 26\nNeg Neg 9 144 153\nSum 35 200 235"}
LitCovid-PD-MONDO
{"project":"LitCovid-PD-MONDO","denotations":[{"id":"T70","span":{"begin":1819,"end":1821},"obj":"Disease"}],"attributes":[{"id":"A70","pred":"mondo_id","subj":"T70","obj":"http://purl.obolibrary.org/obo/MONDO_0017178"}],"text":"Testing clinical samples with the swab–to–RT-LAMP assay\nOn the basis of these preliminary experiments, we decided to use swab samples either directly without any treatment (direct swab–to–RT-LAMP assay) or after heat treatment for 5 min at 95°C (hot swab–to–RT-LAMP assay). As an additional precaution, we kept the samples in the cold (using an ice-cold metal block) whenever possible. For testing large numbers of clinical samples, we performed the RT-LAMP assay using several 96-well plates. In total, we tested 209 different samples using the hot swab–to–RT-LAMP assay, and of these, 131 samples also were tested by the direct swab–to–RT-LAMP assay. Many samples were tested twice but using aliquots withdrawn at different time points (usually within 24 hours) from the swab samples stored at 4°C. This resulted in 235 direct swab–to–RT-LAMP assay measurements and 343 hot swab–to–RT-LAMP assay measurements (Fig. 5A). The hot swab–to–RT-LAMP assay detected a color change in the majority of samples with a CT \u003c 30 with high sensitivity, whereas the direct swab–to–RT-LAMP assay only exhibited a high sensitivity for samples with a CT \u003c 25 (Fig. 5 and Table 3). The heat treatment rendered the RT-LAMP assay more stringent as it reduced false positives and more sensitive for samples with a CT of 25 to 30. We found that some positive samples did not induce a color change but did so when assayed a second time. We therefore would recommend running this assay using technical duplicates.\nFig. 5 Swab–to–RT-LAMP assay of clinical pharyngeal swab samples.\n(A) Skipping a prior RNA isolation step, pharyngeal swab samples were subjected to the RT-LAMP assay either directly (left) or after 5 min of heat treatment at 95°C (right). For each sample, scatter plots are used to compare the swab–to–RT-LAMP assay results (ΔOD values) with the results of RT-qPCR (CT values). The measurement time point was 30 min after the start of the 65°C incubation. (B) Shown is the sensitivity (right) and specificity (left) of the swab–to–RT-LAMP assay [derived from the data in (A)] using the decision threshold indicated by the horizontal gray line in (A). Specificity and sensitivity values (thick lines) are shown with their 95% confidence intervals (boxes) as in Fig. 3, with blue indicating the direct swab–to–RT-LAMP assay and red indicating the hot swab–to–RT-LAMP assay. (Also see table S3).\nTable 3 Shown is RT-qPCR and RT-LAMP testing of 592 clinical samples stratified into CT value bins (see Fig. 5A).\nFig. 5A and table S3 show specificity and sensitivity values calculated from these numbers.\nHot swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 38 4 42\n25–30 17 5 22\n30–35 5 23 28\n35–40 0 36 36\nNeg Neg 1 214 215\nSum 61 282 343\nDirect swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 15 1 16\n25–30 6 11 17\n30–35 2 21 23\n35–40 3 23 26\nNeg Neg 9 144 153\nSum 35 200 235"}
LitCovid-PD-CLO
{"project":"LitCovid-PD-CLO","denotations":[{"id":"T243","span":{"begin":0,"end":7},"obj":"http://purl.obolibrary.org/obo/UBERON_0000473"},{"id":"T244","span":{"begin":390,"end":397},"obj":"http://purl.obolibrary.org/obo/UBERON_0000473"},{"id":"T245","span":{"begin":507,"end":513},"obj":"http://purl.obolibrary.org/obo/UBERON_0000473"},{"id":"T246","span":{"begin":609,"end":615},"obj":"http://purl.obolibrary.org/obo/UBERON_0000473"},{"id":"T247","span":{"begin":671,"end":677},"obj":"http://purl.obolibrary.org/obo/UBERON_0000473"},{"id":"T248","span":{"begin":796,"end":799},"obj":"http://purl.obolibrary.org/obo/CLO_0001387"},{"id":"T249","span":{"begin":961,"end":962},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T250","span":{"begin":1008,"end":1009},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T251","span":{"begin":1097,"end":1098},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T252","span":{"begin":1133,"end":1134},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T253","span":{"begin":1292,"end":1293},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T254","span":{"begin":1361,"end":1362},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T255","span":{"begin":1400,"end":1401},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T256","span":{"begin":1559,"end":1560},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T257","span":{"begin":1571,"end":1572},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T258","span":{"begin":1950,"end":1951},"obj":"http://purl.obolibrary.org/obo/CLO_0001021"},{"id":"T259","span":{"begin":2065,"end":2066},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T260","span":{"begin":2140,"end":2141},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T261","span":{"begin":2424,"end":2431},"obj":"http://purl.obolibrary.org/obo/UBERON_0000473"},{"id":"T262","span":{"begin":2691,"end":2693},"obj":"http://purl.obolibrary.org/obo/CLO_0050507"},{"id":"T263","span":{"begin":2697,"end":2699},"obj":"http://purl.obolibrary.org/obo/CLO_0001000"},{"id":"T264","span":{"begin":2711,"end":2713},"obj":"http://purl.obolibrary.org/obo/CLO_0001000"},{"id":"T265","span":{"begin":2721,"end":2723},"obj":"http://purl.obolibrary.org/obo/CLO_0001313"},{"id":"T266","span":{"begin":2725,"end":2727},"obj":"http://purl.obolibrary.org/obo/CLO_0001313"},{"id":"T267","span":{"begin":2850,"end":2855},"obj":"http://purl.obolibrary.org/obo/CLO_0001046"},{"id":"T268","span":{"begin":2866,"end":2868},"obj":"http://purl.obolibrary.org/obo/CLO_0053733"},{"id":"T269","span":{"begin":2876,"end":2878},"obj":"http://purl.obolibrary.org/obo/CLO_0001000"},{"id":"T270","span":{"begin":2890,"end":2892},"obj":"http://purl.obolibrary.org/obo/CLO_0001000"},{"id":"T271","span":{"begin":2935,"end":2937},"obj":"http://purl.obolibrary.org/obo/CLO_0001000"}],"text":"Testing clinical samples with the swab–to–RT-LAMP assay\nOn the basis of these preliminary experiments, we decided to use swab samples either directly without any treatment (direct swab–to–RT-LAMP assay) or after heat treatment for 5 min at 95°C (hot swab–to–RT-LAMP assay). As an additional precaution, we kept the samples in the cold (using an ice-cold metal block) whenever possible. For testing large numbers of clinical samples, we performed the RT-LAMP assay using several 96-well plates. In total, we tested 209 different samples using the hot swab–to–RT-LAMP assay, and of these, 131 samples also were tested by the direct swab–to–RT-LAMP assay. Many samples were tested twice but using aliquots withdrawn at different time points (usually within 24 hours) from the swab samples stored at 4°C. This resulted in 235 direct swab–to–RT-LAMP assay measurements and 343 hot swab–to–RT-LAMP assay measurements (Fig. 5A). The hot swab–to–RT-LAMP assay detected a color change in the majority of samples with a CT \u003c 30 with high sensitivity, whereas the direct swab–to–RT-LAMP assay only exhibited a high sensitivity for samples with a CT \u003c 25 (Fig. 5 and Table 3). The heat treatment rendered the RT-LAMP assay more stringent as it reduced false positives and more sensitive for samples with a CT of 25 to 30. We found that some positive samples did not induce a color change but did so when assayed a second time. We therefore would recommend running this assay using technical duplicates.\nFig. 5 Swab–to–RT-LAMP assay of clinical pharyngeal swab samples.\n(A) Skipping a prior RNA isolation step, pharyngeal swab samples were subjected to the RT-LAMP assay either directly (left) or after 5 min of heat treatment at 95°C (right). For each sample, scatter plots are used to compare the swab–to–RT-LAMP assay results (ΔOD values) with the results of RT-qPCR (CT values). The measurement time point was 30 min after the start of the 65°C incubation. (B) Shown is the sensitivity (right) and specificity (left) of the swab–to–RT-LAMP assay [derived from the data in (A)] using the decision threshold indicated by the horizontal gray line in (A). Specificity and sensitivity values (thick lines) are shown with their 95% confidence intervals (boxes) as in Fig. 3, with blue indicating the direct swab–to–RT-LAMP assay and red indicating the hot swab–to–RT-LAMP assay. (Also see table S3).\nTable 3 Shown is RT-qPCR and RT-LAMP testing of 592 clinical samples stratified into CT value bins (see Fig. 5A).\nFig. 5A and table S3 show specificity and sensitivity values calculated from these numbers.\nHot swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 38 4 42\n25–30 17 5 22\n30–35 5 23 28\n35–40 0 36 36\nNeg Neg 1 214 215\nSum 61 282 343\nDirect swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 15 1 16\n25–30 6 11 17\n30–35 2 21 23\n35–40 3 23 26\nNeg Neg 9 144 153\nSum 35 200 235"}
LitCovid-PD-CHEBI
{"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T65","span":{"begin":2381,"end":2383},"obj":"Chemical"},{"id":"T66","span":{"begin":2519,"end":2521},"obj":"Chemical"}],"attributes":[{"id":"A65","pred":"chebi_id","subj":"T65","obj":"http://purl.obolibrary.org/obo/CHEBI_29388"},{"id":"A66","pred":"chebi_id","subj":"T66","obj":"http://purl.obolibrary.org/obo/CHEBI_29388"}],"text":"Testing clinical samples with the swab–to–RT-LAMP assay\nOn the basis of these preliminary experiments, we decided to use swab samples either directly without any treatment (direct swab–to–RT-LAMP assay) or after heat treatment for 5 min at 95°C (hot swab–to–RT-LAMP assay). As an additional precaution, we kept the samples in the cold (using an ice-cold metal block) whenever possible. For testing large numbers of clinical samples, we performed the RT-LAMP assay using several 96-well plates. In total, we tested 209 different samples using the hot swab–to–RT-LAMP assay, and of these, 131 samples also were tested by the direct swab–to–RT-LAMP assay. Many samples were tested twice but using aliquots withdrawn at different time points (usually within 24 hours) from the swab samples stored at 4°C. This resulted in 235 direct swab–to–RT-LAMP assay measurements and 343 hot swab–to–RT-LAMP assay measurements (Fig. 5A). The hot swab–to–RT-LAMP assay detected a color change in the majority of samples with a CT \u003c 30 with high sensitivity, whereas the direct swab–to–RT-LAMP assay only exhibited a high sensitivity for samples with a CT \u003c 25 (Fig. 5 and Table 3). The heat treatment rendered the RT-LAMP assay more stringent as it reduced false positives and more sensitive for samples with a CT of 25 to 30. We found that some positive samples did not induce a color change but did so when assayed a second time. We therefore would recommend running this assay using technical duplicates.\nFig. 5 Swab–to–RT-LAMP assay of clinical pharyngeal swab samples.\n(A) Skipping a prior RNA isolation step, pharyngeal swab samples were subjected to the RT-LAMP assay either directly (left) or after 5 min of heat treatment at 95°C (right). For each sample, scatter plots are used to compare the swab–to–RT-LAMP assay results (ΔOD values) with the results of RT-qPCR (CT values). The measurement time point was 30 min after the start of the 65°C incubation. (B) Shown is the sensitivity (right) and specificity (left) of the swab–to–RT-LAMP assay [derived from the data in (A)] using the decision threshold indicated by the horizontal gray line in (A). Specificity and sensitivity values (thick lines) are shown with their 95% confidence intervals (boxes) as in Fig. 3, with blue indicating the direct swab–to–RT-LAMP assay and red indicating the hot swab–to–RT-LAMP assay. (Also see table S3).\nTable 3 Shown is RT-qPCR and RT-LAMP testing of 592 clinical samples stratified into CT value bins (see Fig. 5A).\nFig. 5A and table S3 show specificity and sensitivity values calculated from these numbers.\nHot swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 38 4 42\n25–30 17 5 22\n30–35 5 23 28\n35–40 0 36 36\nNeg Neg 1 214 215\nSum 61 282 343\nDirect swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 15 1 16\n25–30 6 11 17\n30–35 2 21 23\n35–40 3 23 26\nNeg Neg 9 144 153\nSum 35 200 235"}
LitCovid-PD-GO-BP
{"project":"LitCovid-PD-GO-BP","denotations":[{"id":"T158","span":{"begin":42,"end":44},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T159","span":{"begin":188,"end":190},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T160","span":{"begin":258,"end":260},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T161","span":{"begin":450,"end":452},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T162","span":{"begin":558,"end":560},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T163","span":{"begin":638,"end":640},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T164","span":{"begin":837,"end":839},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T165","span":{"begin":884,"end":886},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T166","span":{"begin":938,"end":940},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T167","span":{"begin":1068,"end":1070},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T168","span":{"begin":1197,"end":1199},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T169","span":{"begin":1507,"end":1509},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T170","span":{"begin":1645,"end":1647},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T171","span":{"begin":1795,"end":1797},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T172","span":{"begin":1850,"end":1852},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T173","span":{"begin":2024,"end":2026},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T174","span":{"begin":2301,"end":2303},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T175","span":{"begin":2350,"end":2352},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T176","span":{"begin":2404,"end":2406},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T177","span":{"begin":2416,"end":2418},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T178","span":{"begin":2605,"end":2607},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T179","span":{"begin":2616,"end":2618},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T180","span":{"begin":2645,"end":2647},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T181","span":{"begin":2784,"end":2786},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T182","span":{"begin":2795,"end":2797},"obj":"http://purl.obolibrary.org/obo/GO_0001171"},{"id":"T183","span":{"begin":2824,"end":2826},"obj":"http://purl.obolibrary.org/obo/GO_0001171"}],"text":"Testing clinical samples with the swab–to–RT-LAMP assay\nOn the basis of these preliminary experiments, we decided to use swab samples either directly without any treatment (direct swab–to–RT-LAMP assay) or after heat treatment for 5 min at 95°C (hot swab–to–RT-LAMP assay). As an additional precaution, we kept the samples in the cold (using an ice-cold metal block) whenever possible. For testing large numbers of clinical samples, we performed the RT-LAMP assay using several 96-well plates. In total, we tested 209 different samples using the hot swab–to–RT-LAMP assay, and of these, 131 samples also were tested by the direct swab–to–RT-LAMP assay. Many samples were tested twice but using aliquots withdrawn at different time points (usually within 24 hours) from the swab samples stored at 4°C. This resulted in 235 direct swab–to–RT-LAMP assay measurements and 343 hot swab–to–RT-LAMP assay measurements (Fig. 5A). The hot swab–to–RT-LAMP assay detected a color change in the majority of samples with a CT \u003c 30 with high sensitivity, whereas the direct swab–to–RT-LAMP assay only exhibited a high sensitivity for samples with a CT \u003c 25 (Fig. 5 and Table 3). The heat treatment rendered the RT-LAMP assay more stringent as it reduced false positives and more sensitive for samples with a CT of 25 to 30. We found that some positive samples did not induce a color change but did so when assayed a second time. We therefore would recommend running this assay using technical duplicates.\nFig. 5 Swab–to–RT-LAMP assay of clinical pharyngeal swab samples.\n(A) Skipping a prior RNA isolation step, pharyngeal swab samples were subjected to the RT-LAMP assay either directly (left) or after 5 min of heat treatment at 95°C (right). For each sample, scatter plots are used to compare the swab–to–RT-LAMP assay results (ΔOD values) with the results of RT-qPCR (CT values). The measurement time point was 30 min after the start of the 65°C incubation. (B) Shown is the sensitivity (right) and specificity (left) of the swab–to–RT-LAMP assay [derived from the data in (A)] using the decision threshold indicated by the horizontal gray line in (A). Specificity and sensitivity values (thick lines) are shown with their 95% confidence intervals (boxes) as in Fig. 3, with blue indicating the direct swab–to–RT-LAMP assay and red indicating the hot swab–to–RT-LAMP assay. (Also see table S3).\nTable 3 Shown is RT-qPCR and RT-LAMP testing of 592 clinical samples stratified into CT value bins (see Fig. 5A).\nFig. 5A and table S3 show specificity and sensitivity values calculated from these numbers.\nHot swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 38 4 42\n25–30 17 5 22\n30–35 5 23 28\n35–40 0 36 36\nNeg Neg 1 214 215\nSum 61 282 343\nDirect swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 15 1 16\n25–30 6 11 17\n30–35 2 21 23\n35–40 3 23 26\nNeg Neg 9 144 153\nSum 35 200 235"}
LitCovid-sentences
{"project":"LitCovid-sentences","denotations":[{"id":"T197","span":{"begin":0,"end":55},"obj":"Sentence"},{"id":"T198","span":{"begin":56,"end":273},"obj":"Sentence"},{"id":"T199","span":{"begin":274,"end":385},"obj":"Sentence"},{"id":"T200","span":{"begin":386,"end":493},"obj":"Sentence"},{"id":"T201","span":{"begin":494,"end":652},"obj":"Sentence"},{"id":"T202","span":{"begin":653,"end":800},"obj":"Sentence"},{"id":"T203","span":{"begin":801,"end":921},"obj":"Sentence"},{"id":"T204","span":{"begin":922,"end":1164},"obj":"Sentence"},{"id":"T205","span":{"begin":1165,"end":1309},"obj":"Sentence"},{"id":"T206","span":{"begin":1310,"end":1414},"obj":"Sentence"},{"id":"T207","span":{"begin":1415,"end":1490},"obj":"Sentence"},{"id":"T208","span":{"begin":1491,"end":1557},"obj":"Sentence"},{"id":"T209","span":{"begin":1558,"end":1731},"obj":"Sentence"},{"id":"T210","span":{"begin":1732,"end":1870},"obj":"Sentence"},{"id":"T211","span":{"begin":1871,"end":2143},"obj":"Sentence"},{"id":"T212","span":{"begin":2144,"end":2385},"obj":"Sentence"},{"id":"T213","span":{"begin":2386,"end":2500},"obj":"Sentence"},{"id":"T214","span":{"begin":2501,"end":2592},"obj":"Sentence"},{"id":"T215","span":{"begin":2593,"end":2623},"obj":"Sentence"},{"id":"T216","span":{"begin":2624,"end":2644},"obj":"Sentence"},{"id":"T217","span":{"begin":2645,"end":2676},"obj":"Sentence"},{"id":"T218","span":{"begin":2677,"end":2693},"obj":"Sentence"},{"id":"T219","span":{"begin":2694,"end":2710},"obj":"Sentence"},{"id":"T220","span":{"begin":2711,"end":2727},"obj":"Sentence"},{"id":"T221","span":{"begin":2728,"end":2750},"obj":"Sentence"},{"id":"T222","span":{"begin":2751,"end":2768},"obj":"Sentence"},{"id":"T223","span":{"begin":2769,"end":2802},"obj":"Sentence"},{"id":"T224","span":{"begin":2803,"end":2823},"obj":"Sentence"},{"id":"T225","span":{"begin":2824,"end":2855},"obj":"Sentence"},{"id":"T226","span":{"begin":2856,"end":2872},"obj":"Sentence"},{"id":"T227","span":{"begin":2873,"end":2889},"obj":"Sentence"},{"id":"T228","span":{"begin":2890,"end":2906},"obj":"Sentence"},{"id":"T229","span":{"begin":2907,"end":2929},"obj":"Sentence"},{"id":"T230","span":{"begin":2930,"end":2947},"obj":"Sentence"}],"namespaces":[{"prefix":"_base","uri":"http://pubannotation.org/ontology/tao.owl#"}],"text":"Testing clinical samples with the swab–to–RT-LAMP assay\nOn the basis of these preliminary experiments, we decided to use swab samples either directly without any treatment (direct swab–to–RT-LAMP assay) or after heat treatment for 5 min at 95°C (hot swab–to–RT-LAMP assay). As an additional precaution, we kept the samples in the cold (using an ice-cold metal block) whenever possible. For testing large numbers of clinical samples, we performed the RT-LAMP assay using several 96-well plates. In total, we tested 209 different samples using the hot swab–to–RT-LAMP assay, and of these, 131 samples also were tested by the direct swab–to–RT-LAMP assay. Many samples were tested twice but using aliquots withdrawn at different time points (usually within 24 hours) from the swab samples stored at 4°C. This resulted in 235 direct swab–to–RT-LAMP assay measurements and 343 hot swab–to–RT-LAMP assay measurements (Fig. 5A). The hot swab–to–RT-LAMP assay detected a color change in the majority of samples with a CT \u003c 30 with high sensitivity, whereas the direct swab–to–RT-LAMP assay only exhibited a high sensitivity for samples with a CT \u003c 25 (Fig. 5 and Table 3). The heat treatment rendered the RT-LAMP assay more stringent as it reduced false positives and more sensitive for samples with a CT of 25 to 30. We found that some positive samples did not induce a color change but did so when assayed a second time. We therefore would recommend running this assay using technical duplicates.\nFig. 5 Swab–to–RT-LAMP assay of clinical pharyngeal swab samples.\n(A) Skipping a prior RNA isolation step, pharyngeal swab samples were subjected to the RT-LAMP assay either directly (left) or after 5 min of heat treatment at 95°C (right). For each sample, scatter plots are used to compare the swab–to–RT-LAMP assay results (ΔOD values) with the results of RT-qPCR (CT values). The measurement time point was 30 min after the start of the 65°C incubation. (B) Shown is the sensitivity (right) and specificity (left) of the swab–to–RT-LAMP assay [derived from the data in (A)] using the decision threshold indicated by the horizontal gray line in (A). Specificity and sensitivity values (thick lines) are shown with their 95% confidence intervals (boxes) as in Fig. 3, with blue indicating the direct swab–to–RT-LAMP assay and red indicating the hot swab–to–RT-LAMP assay. (Also see table S3).\nTable 3 Shown is RT-qPCR and RT-LAMP testing of 592 clinical samples stratified into CT value bins (see Fig. 5A).\nFig. 5A and table S3 show specificity and sensitivity values calculated from these numbers.\nHot swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 38 4 42\n25–30 17 5 22\n30–35 5 23 28\n35–40 0 36 36\nNeg Neg 1 214 215\nSum 61 282 343\nDirect swab–to–RT-LAMP RT-LAMP\nCT Pos Neg Sum\nRT-qPCR Pos 0–25 15 1 16\n25–30 6 11 17\n30–35 2 21 23\n35–40 3 23 26\nNeg Neg 9 144 153\nSum 35 200 235"}