Enhancing SARS-CoV-2 Lineage surveillance through the integration of a simple and direct qPCR-based protocol adaptation with established machine learning algorithms

Abstract

The emergence of the SARS-CoV-2 and continuous spread of its descendent lineages have posed unprecedented challenges to the global public healthcare system. Here we present an inclusive approach integrating genomic sequencing and qPCR-based protocols to increment monitoring of variant Omicron sublineages. Viral RNA samples were fast tracked for genomic surveillance following the detection of SARS-CoV-2 by diagnostic laboratories or public health network units in Ceara (Brazil) and analyzed using paired-end sequencing and integrative genomic analysis. Validation of a key structural variation was conducted with gel electrophoresis for the presence of a specific ORF7a deletion within the "BE.9" lineages. A simple intercalating dye-based qPCR assay protocol was tested and optimized through the repositioning primers from the ARTIC v.4.1 amplicon panel, which was able to distinguish between "BE.9" and "non-BE.9" lineages, particularly BQ.1. Three ML models were trained with the melting curve of the intercalating dye-based qPCR that enabled lineage assignment with elevated accuracy. Amongst them, the Support Vector Machine (SVM) model had the best performance and after fine-tuning showed ~96.52% (333/345) accuracy in comparison to the test dataset. The integration of these methods may allow rapid assessment of emerging variants and increment molecular surveillance strategies, especially in resource-limited settings. Our approach not only provides a cost-effective alternative to complement traditional sequencing methods but also offers a scalable analytical solution for enhanced monitoring of SARS-CoV-2 variants for other laboratories through easy-to-train ML algorithms, thus contributing to global efforts in pandemic control.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for the study was issued by the research ethics committee from "Centro de Hematologia e Hemoterapia do Ceara" (HEMOCE) part of the "Secretaria da Saude do Estado do Ceara" (SESA-CE), Brazil, under the reference number 5.290.730. As to SARS-CoV-2 molecular screening and pathogen sequencing, this was conducted as part of public health diagnostic assistance and laboratory surveillance of COVID-19 and related notifiable disease monitoring network, which our group is part of.

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Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present work are contained in the manuscript

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