The LIAISON® MDX is an automated chemiluminescent immunoassay analyzer designed for in vitro diagnostic testing. It performs a range of immunoassay tests, including quantitative and qualitative analyses. The LIAISON® MDX automates sample handling, reagent management, and test processing to provide consistent and reliable test results.
The run was performed using a Direct Amplification Disk, consisting of eight simultaneous reactions (one positive control and seven samples). For the amplification. we used 50 μl of the mix per reaction, 50 μl of positive control, and 50 μl for each seven sample, loaded onto the LIAISON® MDX instrument (DiaSorin S.p.A., Gerenzano, Italy). The software generates an amplicon melting temperature analysis and fluorescence melting curve pattern visualization to allow identification of the SARS-CoV-2 mutations N501Y, G496S, Q498R, Y505H, E484K, E484Q, E484A, and L452R, which are potentially associated with variants: Alpha, Beta, Gamma, Delta, Kappa, Omicron, and others (DiaSorin Molecular, https://molecular.diasorin.com/us/kit/simplexa-sars-cov-2-variants-direct/, accessed on March 6, 2022) (Table 1).
Interpretation of VOCs on the basis of the detection of mutations.
Table 1
WHO Nomenclature
Alpha
Beta
Gamma
Delta
Kappa
Omicron
N501Y, G496S, Q498R. Y505H
Only N501Y
Only N501Y
Only N501Y
Absent
Absent
Presents
E484K
Absent
Present
Present
Absent
Absent
Absent
E484Q
Absent
Absent
Absent
Absent
Present
Absent
E484A
Absent
Absent
Absent
Absent
Absent
Present
L452R
Absent
Absent
Absent
Present
Present
Absent
Sberna G., Fabeni L., Berno G., Carletti F., Specchiarello E., Colavita F., Meschi S., Matusali G., Garbuglia A.R., Bordi L, & Lalle E. (2022). Rapid and qualitative identification of SARS-CoV-2 mutations associated with variants of concern using a multiplex RT-PCR assay coupled with melting analysis. International Journal of Infectious Diseases, 122, 401-404.
Inclusion criteria were: (a) age > 18 years; (b) confirmed SARS-CoV-2 infection; (c) need of invasive mechanical ventilation; (d) meeting the Berlin criteria definition for ARDS. Patients were excluded from the study in case of pregnancy or do-not-resuscitate order. SARS-CoV-2 infection was confirmed by reverse transcriptase-polymerase chain reaction assay (Liaison MDX, Diasorin, Saluggia, Italy) from nasopharyngeal swab specimen or tracheal aspirate. Clinical management was in accordance with current guidelines and specific recommendations for the COVID-19 pandemic by Health Authorities and Scientific Societies [16 (link)].
Spadaro S., Fogagnolo A., Campo G., Zucchetti O., Verri M., Ottaviani I., Tunstall T., Grasso S., Scaramuzzo V., Murgolo F., Marangoni E., Vieceli Dalla Sega F., Fortini F., Pavasini R., Rizzo P., Ferrari R., Papi A., Volta C.A, & Contoli M. (2021). Markers of endothelial and epithelial pulmonary injury in mechanically ventilated COVID-19 ICU patients. Critical Care, 25, 74.
The RT-PCR tests in both institutions were performed through nasopharyngeal swabs (Xpert® Nasopharyngeal Sample Collection Kit for Viruses or eNAT® Transport and Preservation Media plus One pernasal applicator swab). The RNA was first extracted (Seegene Nimbus IVD, Hamilton ELITe Galaxy, Abbott m2000sp or Biomèrieux NUCLISENS® EASYMAG®) and subsequently magnified and identified (Applied Biosystems™ 7500 Fast Dx Real-Time PCR Instrument or Abbott m2000rt) with two different sets (GeneFinder™ COVID-19 Plus RealAmp Kit or Allplex™ 2019-nCoV Assay). A rapid amplification instrument was also used (DiaSorin LIAISON® MDX). All these procedures are in full compliance with the WHO Guidelines [21 ].
Romei C., Falaschi Z., Danna P.S., Airoldi C., Tonerini M., Rocchi E., Fanni S.C., D’Amelio C., Barbieri G., Tiseo G., Arioli R., Paschè A., Karwoski R.A., De Liperi A., Bartholmai B.J, & Carriero A. (2022). Lung vessel volume evaluated with CALIPER software is an independent predictor of mortality in COVID-19 patients: a multicentric retrospective analysis. European Radiology, 32(6), 4314-4323.
The Simplexa GBS Direct assay is a diagnostic assay that uses primers and fluorescent probes to amplify GBS bacterial DNA and an Internal Control DNA (IC) in each specimen. The assay targets a conserved region of the cfb gene to identify S. agalactiae in the specimen and the IC is used to detect PCR failure and/or inhibition. Testing was performed following the package insert. Briefly, 50 µL of Lim broth-enriched specimen and 50 µL of Simplexa GBS Direct Reaction Mix were transferred to the sample and reaction wells, respectively, in the direct amplification disc. Specimen information was added to the instrument software and the disc was loaded into the LIAISON MDX (DiaSorin, Stillwater, MN). The total assay run time was 65 min and up to eight (8 (link)) specimens could be run simultaneously per amplification disc. Any specimens reported as invalid were retested once provided the enrichment broth was available. Positive and negative controls were run on weekly basis.
Sabharwal L., Faron M.L, & Buchan B.W. (2024). Comparison of the Simplexa GBS Direct and ARIES GBS assays for the detection of S. agalactiae in broth-enriched swab specimens. Microbiology Spectrum, 12(4), e04164-23.
This is a prospective cohort study of COVID-19 pneumonia survivors admitted to the respiratory and Intensive care units of the Arcispedale Sant’Anna Hospital (Ferrara, Italy) between October and December 2020. Inclusions criteria were: age > 18 years; confirmed SARS-CoV-2 infection; hospitalization for acute respiratory failure (defined as a PaO2/FiO2 (P/F) ratio ≤ 200 mmHg); need for invasive or noninvasive mechanical ventilation or only oxygen support. SARS-CoV-2 infection was confirmed by reverse-transcriptase-polymerase-chain-reaction assay (Liaison MDX, Diasorin, Saluggia, Italy) from a nasopharyngeal swab specimen. At 12 months from hospital discharge, the survivors of the original cohort were contacted to set up a date for a complete respiratory evaluation, including a medical interview and respiratory function tests. The following exclusions criteria were verified before performing EIT, according to the current evidence [21 (link)]: 1) the presence of pacemaker/ICD, 2) pregnancy and 3) impossibility to position the EIT belt (e.g. for the presence of chest lesions). The study was approved by the ethical committee of the Emilia Romagna (AVEC ethical committee) and informed consent was obtained by the patient or by the next of kin according to the approval of the local Ethics committee. Clinicaltrials.gov: NCT04343053; registration date 13/04/2020.
Scaramuzzo G., Ronzoni L., Campo G., Priani P., Arena C., La Rosa R., Turrini C., Volta C.A., Papi A., Spadaro S, & Contoli M. (2022). Long-term dyspnea, regional ventilation distribution and peripheral lung function in COVID-19 survivors: a 1 year follow up study. BMC Pulmonary Medicine, 22, 408.
The ID NOW COVID-19 assay (Abbott, Chicago, Il, USA) is an isothermal nucleic acid amplification-based. The assay was performed directly from the dry swab in the ED or by transferring 200 microliters of VTM to elution buffer in the sample base and then mixed for 10 seconds per instructions for use at the microbiology laboratory. The Simplexa COVID-19 direct assay (Diasorin, Saluggia, Italy) was chosen as RT-PCR reference test and was performed with the DiaSorin LIAISON® MDX according to the manufacturer's instructions for use. A 50 μl volume of Simplexa COVID-19 Direct kit reaction mix (MOL415 0) was added to the “R” well of the 8-well direct amplification disc followed by addition of 50 μl of non extracted nasopharyngeal swab sample to the “SAMPLE” well. Fluorescent probes are used together with corresponding forward and reverse primers to amplify two different regions of the SARS-CoV-2 genome: ORF1ab and S gene. Data collection and analysis were performed with LIAISON® MDX Studio software. CT values were collected from MDX software.
NguyenVan J.C., Gerlier C., Pilmis B., Mizrahi A., Péan de Ponfilly G., Khaterchi A., Enouf V., Ganansia O, & Le Monnier A. (2021). Prospective evaluation of ID NOW COVID-19 assay used as point-of-care test in an emergency department. Journal of Clinical Virology, 145, 105021.
The RT-PCR results were obtained from the patient’s electronic medical records stored in our hospital information system. Some patients (n = 51) with positive chest CT and negative RT-PCR findings repeated the nasopharyngeal swab within 7 days of the CT scan. Additionally, 41 patients with negative CT scan and negative RT-PCR repeated the swab within the allowed time interval. The positivity to SARS-CoV-2 was then confirmed by at least one RT-PCR. These assays were performed by means of nasopharyngeal swabs (Xpert® Nasopharyngeal Sample Collection Kit for Viruses or eNAT® Transport and Preservation Media plus One pernasal applicator swab). The viral RNA was first extracted (Seegene Nimbus IVD, Hamilton ELITe Galaxy, Abbott m2000sp or Biomèrieux NUCLISENS® EASYMAG®) and then amplified and detected (Applied Biosystems™ 7500 Fast Dx Real-Time PCR Instrument or Abbott m2000rt) using two different kits (GeneFinderTM COVID-19 Plus RealAmp Kit or Allplex™ 2019-nCoV Assay). Moreover, in our Institute a fast direct sample amplification instrument was also used (DiaSorin LIAISON® MDX). All these procedures are in full compliance with the WHO Guidelines [17 ].
Falaschi Z., Danna P.S., Arioli R., Pasché A., Zagaria D., Percivale I., Tricca S., Barini M., Aquilini F., Andreoni S, & Carriero A. (2020). Chest CT accuracy in diagnosing COVID-19 during the peak of the Italian epidemic: A retrospective correlation with RT-PCR testing and analysis of discordant cases. European Journal of Radiology, 130, 109192.
Briefly, 50 μl of sample and 50 μl of reaction mixture were separately loaded into Direct real-time PCR amplification-disc wells and onto a LIAISON® MDX instrument (DiaSorin Molecular) and allowed to react for a 75-min run. Positive and negative controls were included in each run. After assay’s completion, the instrument’s Studio software automatically calculated and displayed results. A positive result (i.e., a CT less than 40) for at least one of two viral targets (i.e., S and ORF1ab genes) indicates the presence of SARS-CoV-2 RNA in the patient sample. As with the Allplex™ 2019-nCoV assay, an invalid result requires sample retesting.
Liotti F.M., Menchinelli G., Marchetti S., Morandotti G.A., Sanguinetti M., Posteraro B, & Cattani P. (2020). Evaluation of three commercial assays for SARS-CoV-2 molecular detection in upper respiratory tract samples. European Journal of Clinical Microbiology & Infectious Diseases, 40(2), 269-277.
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