Assessment of SARS-CoV2 genome sequence recovery from four lateral flow device products available in the UK

Lateral flow tests have played a key role in the response to the COVID-19 pandemic and are likely to be a major component of diagnostic strategies to combat future outbreaks of infectious disease. One challenge posed by widescale use of lateral flow tests in the community is the loss of sequence information to track virus evolution and epidemiology.

Beyond their primary diagnostic function, it has been demonstrated that recovery of viral RNA for genome sequencing purposes is possible, from positive lateral flow devices (LFDs).

To assess the robustness and broader applicability of this process, we assessed SARS-CoV-2 RNA recovery and sequencing from the four major LFDs in use in the UK.

Testing both cultured virus and residual clinical nasal swab samples demonstrated that sequencing from LFD eluates is possible, at clinically relevant titres, within a reasonable processing time frame post-use, and gave sequences concordant with routine methods, but results varied across the four devices used.

This highlights the requirement for refinement of existing LFDs or of second–generation LFD design, where sequencing is an intended output from positive LFDs.