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Oxford University Press - PMC COVID-19 Collection logoLink to Oxford University Press - PMC COVID-19 Collection
. 2020 May 7:hvaa106. doi: 10.1093/clinchem/hvaa106

Metagenomic analysis reveals clinical SARS-CoV-2 infection and bacterial or viral superinfection and colonization

Vikas Peddu h1, Ryan C Shean h1, Hong Xie h1, Lasata Shrestha h1, Garrett A Perchetti h1, Samuel S Minot h2, Pavitra Roychoudhury h1,h2, Meei-Li Huang h1, Arun Nalla h1, Shriya B Reddy h3, Quynh Phung h1, Adam Reinhardt h1, Keith R Jerome h1,h2,#, Alexander L Greninger h1,h2,#
PMCID: PMC7239240  PMID: 32379863

Abstract

Background

More than two months separated the initial description of SARS-CoV-2 and discovery of its widespread dissemination in the United States. Despite this lengthy interval, implementation of specific quantitative reverse transcription (qRT)-PCR-based SARS-CoV-2 tests in the US has been slow, and testing is still not widely available. Metagenomic sequencing offers the promise of unbiased detection of emerging pathogens, without requiring prior knowledge of the identity of the responsible agent or its genomic sequence.

Methods

To evaluate metagenomic approaches in the context of the current SARS-CoV-2 epidemic, laboratory-confirmed positive and negative samples from Seattle, Washington were evaluated by metagenomic sequencing, with comparison to a 2019 reference genomic database created before the emergence of SARS-CoV-2.

Results

Within 36 hours our results showed clear identification of a novel human Betacoronavirus, closely related to known Betacoronaviruses of bats, in laboratory-proven cases of SARS-CoV-2. A subset of samples also showed superinfection or colonization with human parainfluenza virus 3 or Moraxella species, highlighting the need to test directly for SARS-CoV-2 as opposed to ruling out an infection using a viral respiratory panel. Samples negative for SARS-CoV-2 by RT-PCR were also negative by metagenomic analysis, and positive for Rhinovirus A and C. Unlike targeted SARS-CoV-2 qRT-PCR testing, metagenomic analysis of these SARS-CoV-2 negative samples identified candidate etiological agents for the patients’ respiratory symptoms.

Conclusion

Taken together, these results demonstrate the value of metagenomic analysis in the monitoring and response to this and future viral pandemics.


Articles from Clinical Chemistry are provided here courtesy of Oxford University Press

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