Clinical Performance of the Reverse Transcription-Loop-Mediated Isothermal Amplification Assay for the Diagnosis of COVID-19 in a Thai Community Hospital at the Thailand-Myanmar Border

Thanee Wongchai; Nuttagarn Chuenchom; Wiphat Klayut; Benjawan Phetsuksiri; Payu Bhakdeenuan; Supranee Bunchoo; Sopa Srisungngam; Janisara Rudeeaneksin

doi:10.7759/cureus.54447

Clinical Performance of the Reverse Transcription-Loop-Mediated Isothermal Amplification Assay for the Diagnosis of COVID-19 in a Thai Community Hospital at the Thailand-Myanmar Border

Cureus. 2024 Feb 19;16(2):e54447. doi: 10.7759/cureus.54447. eCollection 2024 Feb.

Authors

Thanee Wongchai¹, Nuttagarn Chuenchom², Wiphat Klayut³, Benjawan Phetsuksiri³, Payu Bhakdeenuan³, Supranee Bunchoo³, Sopa Srisungngam³, Janisara Rudeeaneksin³

Affiliations

¹ Infectious Diseases, Mae Sot Hospital, Ministry of Public Health, Tak, THA.
² Hospital Medicine, Mae Sot Hospital, Ministry of Public Health, Tak, THA.
³ Infectious Diseases, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, THA.

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) continues to be a global health threat and is a public health issue in Thailand and other countries. The extensive cross-border between Thailand and Myanmar is considered to be at a potentially high risk for COVID-19 distribution in this region. In this instance, simple and cost-effective tests for rapid and early detection of COVID-19 would be useful for effective patient management and control of the disease.

Methods: This study was conducted at Mae Sot Hospital on the border of Thailand-Myanmar to evaluate the diagnostic performance of a simple colorimetric reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay developed recently for the rapid detection of SARS-CoV-2. Nasopharyngeal specimens were routinely collected and processed through automated nucleic acid extraction followed by real-time reverse transcription-polymerase chain reaction (rRT-PCR) using the Molaccu^® COVID-19 Detection Kit. The RT-LAMP assay was further performed on remnant RNA samples, and the visual results were compared to those of rRT-PCR as a reference.

Results: Of the 727 samples tested, the RT-LAMP assay could detect 322 out of 374 samples positive for SARS-CoV-2 by rRT-PCR with 100% (n = 353/353) negative agreement. The comparative analysis demonstrated the overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the RT-LAMP at 92.85% (n = 675/727, 95% CI: 90.73-94.61), 86.10% (n = 322/374, 95% CI: 82.17-89.44), 100% (n = 353/353, 95% CI: 98.96-100), 100% (n = 322/322, 95% CI: 98.86-100), and 87.16% (n = 353/405, 95% CI: 84.06-89.73), respectively.

Conclusion: This RT-LAMP assay showed good diagnostic performance in the hospital setting. It can increase laboratory capacity for rapid SARS-CoV-2 testing and has the potential for use as an alternative or a backup assay at the point of need, especially where alternatives are unavailable for any reason, such as a decline in COVID-19 cases.

Keywords: covid-19; hospital; rrt-pcr; rt-lamp; sars-cov-2.