FDA monitoring impact of SARS-CoV-2 mutations

The US Food and Drug Administration (FDA) has announced that it is monitoring the potential impact of SARS-CoV-2 viral mutations, including a variant from the UK known as the B.1.1.7 variant. The FDA has alerted clinical laboratory staff and healthcare providers that the agency is using authorised SARS-CoV-2 molecular tests and that false negative results can occur with any molecular test for the detection of SARS-CoV-2 if a mutation occurs in the part of the virus’s genome assessed by that test.

The FDA says it is taking additional actions to ensure authorised tests remain accurate by working with test developers and conducting ongoing data analysis to evaluate all currently authorised molecular tests. The FDA believes the risk that these mutations will impact overall testing accuracy is low.

According to the FDA, it has been monitoring SARS-CoV-2 viral mutations and the potential impact on testing throughout the pandemic. The presence of SARS-CoV-2 genetic variants in a patient sample can potentially change the performance of a SARS-CoV-2 test. However, tests that rely on the detection of multiple regions of the genome may be less impacted by genetic variation in the SARS-CoV-2 genome than tests that rely on detection of only a single region. 

“The FDA will continue to monitor SARS-CoV-2 genetic viral variants to ensure authorised tests continue to provide accurate results for patients,” said FDA Commissioner Dr Stephen Hahn. “While these efforts continue, we are working with authorised test developers and reviewing incoming data to ensure that healthcare providers and clinical staff can quickly and accurately diagnose patients infected with SARS-CoV-2, including those with emerging genetic variants. At this time, we believe the data suggests that the currently authorised COVID-19 vaccines may still be effective against this strain.” 

Three currently authorised molecular tests, MesaBiotech Accula, TaqPath COVID-19 Combo Kit and Linea COVID-19 Assay Kit, may be impacted by genetic variants of SARS-CoV-2, the FDA says, but the impact does not appear to be significant. Importantly, the detection pattern that appears with the TaqPath and Linea diagnostic tests when certain genetic variants are present may help with early identification of new variants in patients to reduce further spread of infection. The recently identified B.1.1.7 variant has been associated with an increased risk of transmission, therefore early identification of this variant in patients may help reduce further spread of infection.

The FDA has reminded clinical laboratory staff and health care providers about the risk of false negative results with all laboratory tests, including molecular tests. Laboratories should expect some false results to occur even when very accurate SARS-CoV-2 tests are used. Today’s announcement also provides important information and recommendations for clinical laboratory staff and health care providers who use molecular tests for the detection of SARS-CoV-2.