Journal
SCIENCE ADVANCES
Volume 7, Issue 7, Pages -Publisher
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/sciadv.abe5054
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Funding
- Wellcome Project Heron
- Wellcome Sanger Institute core grant from Wellcome [WT206194]
- Wellcome Trust
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INSIGHT is a two-stage COVID-19 testing strategy that combines point-of-care diagnosis with next-generation sequencing to achieve population-scale testing; the first stage provides quick decentralized readout, aiming for early isolation of asymptomatic patients and gives results within 1 to 2 hours; the second stage confirms near-patient testing results and facilitates centralized data collection.
We present INSIGHT [isothermal NASBA (nucleic acid sequence-based amplification) sequencing-based high-throughput test], a two-stage coronavirus disease 2019 testing strategy, using a barcoded isothermal NASBA reaction. It combines point-of-care diagnosis with next-generation sequencing, aiming to achieve population-scale testing. Stage 1 allows a quick decentralized readout for early isolation of presymptomatic or asymptomatic patients. It gives results within 1 to 2 hours, using either fluorescence detection or a lateral flow readout, while simultaneously incorporating sample-specific barcodes. The same reaction products from potentially hundreds of thousands of samples can then be pooled and used in a highly multiplexed sequencing-based assay in stage 2. This second stage confirms the near-patient testing results and facilitates centralized data collection. The 95% limit of detection is <50 copies of viral RNA per reaction. INSIGHT is suitable for further development into a rapid home-based, point-of-care assay and is potentially scalable to the population level.
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