The following description relates to collecting and analyzing swab samples, for example, in the context of medical testing and diagnosis or another context.
Swab samples are often collected to diagnose diseases. Conventionally, a swab sample is collected by inserting a clean swab into a target region of a subject (e.g., into the subject's nose, throat, etc.) to collect a sample from the target region. The swab sample is then extracted from the subject and analyzed for the presence of disease markers.
As an example, a nasopharyngeal swab is often used to collect nasal secretions from the nasopharynx, and the nasopharyngeal swab sample may then be analyzed to test for whooping cough, diphtheria, influenza, diseases (e.g., SARS, MERS, and COVID-19) caused by the coronavirus family of viruses, and others. As another example, a throat swab is often used to collect saliva from the throat, and the throat swab sample may then be analyzed to test for bacteria or fungus that cause diseases such as strep throat, pneumonia, tonsillitis, and others.
In some aspects of what is described here, a swab sample analysis system includes a sampling device, a control system, and a mass spectrometer. The sampling device may be positioned on a sample surface (which may contain specimen collected from a patient) to receive a liquid solvent from the control system, to form an analyte (which may include at least a portion of the specimen collected on the sample surface), and to transfer the analyte to the mass spectrometer. The sampling device may be directly configured to receive a swab sample containing a specimen collected from a patient and to perform an on-site testing and screening. In certain examples, the swab sample analysis system may be formatted as a cartridge for high-throughput testing of multiple swab samples. The analyte received from the sampling device can be processed by the mass spectrometer. In some instances, disease markers in the swab samples can be identified, and the disease can be diagnosed (e.g., using a statistical classification model or another type of analysis).
In some examples, swab samples are collected (e.g., using nasal swab, nasopharyngeal swab, oropharyngeal swab, throat swab, etc.) to identify the presence of disease markers. The swab samples may include nasal swab samples (containing material from a nasal passage), nasopharyngeal swab samples (containing material from the nasopharynx), oropharyngeal swab samples (containing material from the oropharynx), throat swab samples (containing material from the throat) or other types of swab samples collected from a target region of a subject. The swab sample may then be processed by a mass spectrometer, and the mass spectrometry data may then be analyzed to detect disease markers.
In some examples, swab samples are tested to diagnose diseases, and the systems and techniques described here may be adapted to test for a wide range of diseases. For example, the systems and techniques described here may be adapted to test swab samples for bacterial infections, viral diseases, fungal infections, or other related pathogens and microorganisms. In some implementations, the systems and techniques described here may be adapted to test swab samples for whooping cough, diphtheria, influenza, diseases (e.g., SARS, MERS, and COVID-19) caused by the coronavirus family of viruses, strep throat, pneumonia, and tonsillitis.
In some of the examples described here, swab samples are tested to diagnose COVID-19 or another type of coronavirus disease. There is an urgent need for accelerated development and deployment of diagnostic tests for coronavirus diseases. Notably, the current need has arisen due to the global COVID-19 pandemic. Current diagnostic assays for coronavirus disease are largely based on the detection of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus via quantitative polymerase chain reaction (qPCR) analysis. While PCR assays are powerful and highly sensitive, clinical laboratories have been facing immense challenges in keeping up with the current demands due to limited availability of PCR test reagents, failing PCR instrumentation that are being overrun beyond their capabilities, and the low throughput of PCR analysis. Serological tests targeting host antibodies are being deployed for the coronavirus disease diagnosis and are yielding highly promising results, yet their limited sensitivity at early infection stages represents a potential challenge for patient screening.
The current global pandemic illustrates the need for improved systems and methodologies for collecting and analyzing swab samples. As we have seen, the need to rapidly diagnose novel diseases can arise in a matter of weeks or months, which demonstrates a further advantage in developing systems and methodologies that can be adapted to diagnose other diseases (e.g., currently known diseases, and other diseases that may arise in the future).
In some implementations, the methods and systems disclosed here may provide technical advantages and improvements relative to conventional techniques. In some instances, the methods and systems described here use a common and inexpensive laboratory solvent without using primers and/or amplification. In some instances, the methods and systems described here can provide high molecular specificity and sensitivity for detecting diseases. In some instances, the methods and systems described here can provide high sensitivity and selectivity for untargeted chemical analysis of molecules such as metabolites, lipids, and proteins from pathogen/host with minimal sample preparation requirements. Additionally, simplified operational steps and system design may be utilized without requiring experienced professionals to perform such analysis and diagnosis, which allows the use of such systems and methods as a rapid screening tool and deployed publicly without being limited by the capacity of healthcare workforce. In some instances, the methods and systems described here can potentially minimize risks for healthcare professionals that are at this time being exposed to the aerosols formed during the swabbing procedure currently employed in the clinic for specimen collection. In some instances, the methods and systems described here can identify clinically relevant prognostic biomarkers for diseases to predict clinical courses to enable proactively planning for healthcare resources. In some cases, a combination of these and potentially other advantages and improvements may be obtained.
In some implementations, a sampling device includes a tip portion and a housing. In some implementations, the tip portion, e.g., the tip portion as shown in
In some implementations, the liquid supply channel is configured for receiving a liquid solvent from an external container, for guiding the liquid solvent to the internal reservoir at the tip portion, where the liquid solvent may be in direct contact with the swab sample inserted into the internal reservoir through an opening, and for filling up at least a portion of the internal reservoir with the liquid solvent. In some implementations, the liquid extraction channel is configured for obtaining an analyte from the internal reservoir by extracting at least a portion of the liquid solvent carrying suspended cells and/or extracted molecules from the cells, and for guiding the analyte to the transfer tube.
In some implementations, a fixed volume of liquid solvent is communicated into the tip portion. The fixed volume of fluid can be retained within the internal reservoir while in direct contact with the sample surface for a controlled amount of time, to form an analyte containing molecules from the sample surface. The analyte may then be extracted (e.g., as a single, discrete droplet of fluid) from the internal reservoir through the liquid extraction channel for analysis. In some instances, the analyte is produced by the probe in a non-destructive manner that does not damage the sample surface. For instance, the probe may extract the analyte from a tissue site or tissue sample without causing any detectable damage or destruction to the tissue.
In some implementations, a swab sample analysis system includes an ionization system which can receive the analyte from the sampling device via the transfer tube and can be used to ionize the analyte to produce ions of the molecules in the suspended cells and/or extracted molecules from the cells. In some instances, the ionization system contains an electrospray ionization source under vacuum that can be directly integrated between a sampling device and a mass spectrometer. In some instances, the vacuum created within the ionization system, for example in a chamber, can provide a driving force required to extract/transport an analyte from the sampling device to the ionization system. In some instances, the ionization system can be used to improve the ionization efficiency, sensitivity, and reproducibility of the swab sample analysis system.
In some implementations, a swab sample analysis system includes a mass spectrometer that produces mass spectral data which can include molecular profiles for differentiation and identification of disease markers. In some implementations, the swab sample analysis system includes a statistical classification model to provide separations of strains according to the molecular profiles. In some instances, fa statistical classification model, e.g., a multi-level LASSO model, may allow discrimination of disease markers (e.g., markers for SARS-CoV-2 virus and its various strains, etc.).
In the example shown in
In some implementations, the computer system 102 may include a single computing device, or multiple computers that operate in proximity to, or remote from, the rest of the example system 100 (e.g., the control system 106, and the mass spectrometer 108). In some implementations, the computer system 102 may communicate with the rest of the example system 100 via the communication interface 128 through a communication network, e.g., a local area network (LAN), a wide area network (WAN), an inter-network (e.g., the Internet), a network comprising a satellite link, and peer-to-peer networks (e.g., ad hoc peer-to-peer networks).
In some implementations, the sampling device 104 may be configured to communicate fluids with the control system 106 and the mass spectrometer 108 via transfer tubes. In some instances, the sampling device 104 may receive liquid solvent from the control system 106, guide the liquid solvent to a sample 110 with specimen collected from a patient, obtain an analyte by extracting at least a portion of the liquid solvent from the sample 110, and deliver the analyte containing suspended viruses/host cells and molecules extracted from the viruses/host cells to the mass spectrometer 108. In some implementations, the sampling device 104 may include a tip portion, which may include multiple internal liquid/gas channels and an internal reservoir, e.g., the channels 312, 314, 316 and the internal reservoir 318 as shown in
The control system 106 controls the movement of fluid in the swab sample analysis system 100. In some implementations, the control system 106 may include a mechanical pumping system and one or more mechanical valves. In some instances, the mechanical pumping system contains a mechanical pump that is controlled by the computer system 102. For example, the mechanical pumping system may be implemented as the mechanical pumping system 228 as shown in
In some implementations, an analyte may be received by the mass spectrometer 108. In some instances, the analyte may include the liquid solvent and one or more of the following: pathogen molecules, molecules from cells of the host, or molecules in secretions produced by the cells of the host. In some implementations, the analyte may be extracted from the sampling device 202 by creating a low pressure in the mass spectrometer 108. For example, the low pressure can be created by a vacuum pump attached to the mass spectrometer 108. In some implementations, prior to the mass spectrometer, the analyte may be collected and delivered to an ion optic system. In some instances, the ion optic system may be configured to filter neutral species in the analyte, to allow ions passing through, and to eliminate contamination of the mass spectrometer 108. In some implementations, the mass spectrometer 108 may include a mass selector and a mass analyzer, which are configured to separate and identify the ionization products in the ionized analyte according to their mass-to-charge (m/z) ratio. In some implementations, the mass spectrometer 108 may output a set of mass spectra (e.g., intensity of the ionized product vs. the m/z ratio) to the computer system 102, which may be stored in the memory 122, analyzed by running a program 126 and results may be further displayed on the display 130. In some implementations, the mass spectrometer 108 may be implemented as the mass spectrometer 230 as shown in
In some implementations, some of the processes and logic flows described in this specification can be automatically performed by one or more programmable processors, e.g. processor 120, executing one or more computer programs to perform actions by operating on input data and generating output. For example, the processor 120 can run the programs 126 by executing or interpreting scripts, functions, executables, or other modules contained in the programs 126. In some implementations, the processor 120 may perform one or more of the operations described, for example, with respect to
In some implementations, the processor 120 can include various kinds of apparatus, devices, and machines for processing data, including, by way of example, a programmable data processor, a system on a chip, or multiple ones, or combinations, of the foregoing. In certain instances, the processor 120 may include special purpose logic circuitry, e.g., an Arduino board, an FPGA (field programmable gate array), an ASIC (application specific integrated circuit), or a Graphics Processing Unit (GPU) for running the deep learning algorithms. In some instances, the processor 120 may include, in addition to hardware, code that creates an execution environment for the computer program in question, e.g., code that constitutes processor firmware, a protocol stack, a database management system, an operating system, a cross-platform runtime environment, a virtual machine, or a combination of one or more of them. In some examples, the processor 120 may include, by way of example, both general and special purpose microprocessors, and processors of any kind of digital computer.
In some implementations, the processor 120 may include both general and special purpose microprocessors, and processors of any kind of quantum or classic computer. Generally, a processor 120 receives instructions and data from a read-only memory or a random-access memory or both, e.g. memory 122. In some implementations, the memory 122 may include all forms of non-volatile memory, media and memory devices, including by way of example semiconductor memory devices (e.g., EPROM, EEPROM, flash memory devices, and others), magnetic disks (e.g., internal hard disks, removable disks, and others), magneto optical disks, and CD ROM and DVD-ROM disks. In some cases, the processor 120 and the memory 122 can be supplemented by, or incorporated in, special purpose logic circuitry.
In some implementations, the data 124 stored in the memory 122 may include, operational parameters, a standard reference database and output data. In some instances, the standard reference database includes a mass spectral reference library, which may be used for identification of disease markers. In some implementations, the programs 126 can include software applications, scripts, programs, functions, executables, or other modules that are interpreted or executed by the processor 120. In some implementations, the programs 126 may include machine-readable instructions for performing deep learning algorithms. In some instances, the programs 126 may include machine-readable instructions for delivering the liquid solvent to the sampling device, and collecting the analyte from the sampling device. In some instances, the programs 126 may obtain input data from the memory 122, from another local source, or from one or more remote sources (e.g., via a communication link). In some instances, the programs 126 may generate output data and store the output data in the memory 122, in another local medium, or in one or more remote devices (e.g., by sending the output data via the communication network 106). In some examples, the programs 126 (also known as, software, software applications, scripts, or codes) can be written in any form of programming language, including compiled or interpreted languages, declarative or procedural languages. In some implementations, the programs 126 can be deployed to be executed on the computer system 102.
In some implementations, the communication interface 128 may be connected to a communication network, which may include any type of communication channel, connector, data communication network, or other link. In some instances, the communication interface 128 may provide communication with other systems or devices. In some instances, the communication interface 128 may include a wireless communication interface that provides wireless communication under various wireless protocols, such as, for example, Bluetooth, Wi-Fi, Near Field Communication (NFC), GSM voice calls, SMS, EMS, or MMS messaging, wireless standards (e.g., CDMA, TDMA, PDC, WCDMA, CDMA2000, GPRS) among others. In some examples, such communication may occur, for example, through a radio-frequency transceiver or another type of component. In some instances, the communication interface 128 may include a wired communication interface (e.g., USB, Ethernet) that can be connected to one or more input/output devices, such as, for example, a keyboard, a pointing device, a scanner, or a networking device such as a switch or router, for example, through a network adapter.
In some implementations, the communication interface 128 can be coupled to input devices and output devices (e.g., the display device 130, the input device 132, or other devices) and to one or more communication links. In the example shown, the display device 130 is a computer monitor for displaying information to the user or another type of display device. In some implementations, the input device 132 is a keyboard, a pointing device (e.g., a mouse, a trackball, a tablet, and a touch sensitive screen), or another type of input device, by which the user can provide input to the computer system 102. In some examples, the computer system 102 may include other types of input devices, output devices, or both (e.g., mouse, touchpad, touchscreen, microphone, motion sensors, etc.). The input devices and output devices can receive and transmit data in analog or digital form over communication links such as a wired link (e.g., USB, etc.), a wireless link (e.g., Bluetooth, NFC, infrared, radio frequency, or others), or another type of link.
In some implementations, other kinds of devices may be used to provide for interaction with a user as well; for example, feedback provided to the user can be any form of sensory feedback, e.g., visual feedback, auditory feedback, or tactile feedback; and input from the user can be received in any form, including acoustic, speech, or tactile input. For example, the sampling device 104 may contain a control element (e.g., button, pedal, etc.) which may be used as a controller to initiate, interrupt, restart, or terminate a detection process (e.g., the pedal 226 as shown in
In the example shown in
In some implementations, the sampling device 202 may be manufactured using a 3D printing process, a machining process or another process. In some implementations, the housing 208A of the sampling device 202 may include two internal channels which are fluidically coupled with respective transfer tubes 206A, 206B and respective channels in the tip portion 208B. In some implementations, the transfer tubes 206A, 206B are configured for supplying a liquid solvent from the control system 204 to the tip portion 208B and to obtain an analyte by collecting at least a portion of the liquid solvent with suspended viruses/host cells and extracted molecules from the tip portion 208B. The sampling device 202 may also include a gas channel (e.g., an open port that receives air from the surrounding atmosphere) that allows liquid to be flushed from the sampling device 202, for example, between uses or at other instances.
In some implementations, the tip portion 208B may be detachable from the housing 208A, which can be disposed and replaced if contaminated, e.g., after a certain number (e.g., one or more) of regular uses or when switching between different samples. In some cases, the tip portion 208B may include internal channels that are fluidically coupled to the respective channels in the housing 208A and further to the respective transfer tubes 206A, 206B. In some implementations, the tip portion 208B may be integrated with the housing 208A as a monolithic structure. In some implementations, the tip portion 208B may be implemented as the tip portion 302 as shown in
In some implementations, the control system 204 may include an external container and a mechanical pumping system 228. In some instances, the mechanical pumping system 228 may contain one or more mechanical pumps. In some instances, the one or more mechanical pumps may be programmable. In certain examples, the one or more mechanical pumps may be controlled by a computer system, e.g., the computer system 102 in
As shown in
In some implementations, the transfer tubes 206A, 206B may have a length in the range of approximately half a meter to one or more meters (e.g., a length in the range of approximately 0.5 m to 1.5 m, or in another range) to allow free handheld use of the sampling device 202 by an operator without geometrical or spatial constraints.
In some implementations, the analyte may be collected and delivered to an ion optic system prior to the mass spectrometer 230. In some instances, the ion optic system may be configured to filter neutral species in the analyte, to allow ions passing through, and to eliminate contamination to the mass spectrometer 230.
In some implementations, the mass spectrometer 230 may include a mass selector and a mass analyzer. In some implementations, the mass selector may separate charged biomolecules according to their mass-to-charge (m/z) ratio based on dynamics of charged particles in electric and magnetic field in vacuum. The mass selector may include a set of magnets providing a magnetic field, which the charged molecules travel through. The mass selector may use the magnetic field to alter the path of the charged molecules so that they can be separated according to their charges and mass. In some examples, the mass analyzer may output a set of mass spectra (or mass spectrometry data in another format) for data analysis.
In some implementations, when an analysis is completed by the mass spectrometer 230, the mass spectrometer 230 may produce a report with analysis results, for example, a strain type of the SARS-CoV-2 virus. In some instances, mass spectrometry data produced by the mass spectrometer 230 may be analyzed, and the results of the analysis can be used to determine an appropriate treatment for a patient.
As shown in a cross-sectional view of the tip portion 302 in
In some implementations, the housing 304 is configured to provide fluidic communication with a control system and a mass spectrometer through respective transfer tubes, e.g., the transfer tubes 206A, 206B as shown in
In some implementations, the sample surface 320 may be a surface of a solid substrate. For example, the sample surface 320 may be a glass slide, a 24-well Polytetrafluoroethylene (PTFE)-coated glass slide, a petri dish, or an agar plate. In some implementations, the sample surface 320 contacts the mandrel end 306 of the tip portion 302 to form a seal (e.g., a liquid-tight seal), in order to prevent leakage of the liquid solvent from the internal reservoir 318. In some implementations, the sample surface 320 may contain specimen collected from a patient. For example, the specimen may be collected using a swab, e.g., nasal, nasopharyngeal, oropharyngeal, or throat swab, extracted into a vial of solvent, and transferred onto the sample surface 320. In some instances, the sampling device is used to collect an analyte in order to determine whether the sample surface 320 does or does not contain a disease marker (e.g., SARS-CoV-2 virus or another).
In some aspects of operation, the liquid supply channel 312 receives the liquid solvent from an external container, guides the liquid solvent to the internal reservoir 318 at the tip portion 302, where the liquid solvent may be in direct contact with the sample surface 320 via an opening 326, and fills at least a portion of the internal reservoir 318 with the liquid solvent. The liquid supply channel 312 may provide a first internal pathway 332 in the tip portion. In some implementations, the liquid solvent may be received from the external container as a part of a control system, e.g., the syringe pump as shown in
In some implementations, the internal reservoir 318 may have a cylindrical shape and be coupled to the liquid supply channels 312. In certain examples, the liquid solvent received from the liquid supply channel 312 in the internal reservoir 318 makes direct contact with the sample surface 320. In some instances, at least a portion of a specimen collected from a patient may be suspended such that molecules from cells in a virus may be extracted into the liquid solvent. In some implementations, the diameter 322 of the internal reservoir 318 is determined by, for example, the size of the sample surface 320 and the amount of the virus on the sample surface 320. In some instances, the diameter 322 and height 324 of the internal reservoir 318 may determine the volume of the liquid solvent exposed to the sample surface 320 and performance aspects of the chemical measurement system, for example a spatial resolution, limit of detection, and accuracy. In some instances, the diameter of the internal reservoir 318 of the tip portion 302 may be in a range of 1.5-5.0 mm. For example, when the diameter 322 of the internal reservoir is 2.77 mm and the height 324 of the internal reservoir 318 is 1.7 mm, the volume of a liquid solvent that is contained in the internal reservoir 318 is 10 microliter (4). For another example, when the diameter of the internal reservoir 318 is 1.5 mm and the height 324 is 2.5 mm, the volume of a liquid solvent that is contained in the internal reservoir 318 is 4.4 μL. The internal reservoir 318 may have a different shape, aspect ratio, size or dimension.
In some instances, the liquid extraction channel 314 provides a second, distinct internal pathway 334 in the tip portion 302. In some aspects of operation, the liquid extraction channel 314 obtains an analyte which includes at least a portion of the liquid solvent carrying the suspended cells or the extracted molecules from the internal reservoir 318, extracts and guides the analyte to the transfer tube that is coupled to a mass spectrometer. In some implementations, the analyte from the internal reservoir 318 may be extracted by a vacuum pump coupled to the mass spectrometer (e.g., the mass spectrometer 230 as shown in
In some implementations, the gas channel 316 provides a third, distinct internal pathway 336 in the tip portion 302. In some instances, the gas channel 316 is configured for preventing collapse of the sampling device, transfer tubes and the control system during the extraction. In some instances, the gas channel 316 is open to atmosphere (e.g., air). In some instances, diameters of the liquid supply channel 312, the liquid extraction channel 314 and the gas channel 316 may be equal to 0.8 mm. Gas from the gas channel 316 may be used to push the liquid out of the liquid extraction channel 314 to the mass spectrometer.
At 402, a specimen from a swab head is extracted into a liquid solvent. The specimen can include a swab sample collected from a patient. In some instances, the specimen may include material collected using a nasal swab, nasopharyngeal swab, oropharyngeal swab, throat swab, or another type of swab. In some instances, the swab head is placed into a sterile viral transportation mediate tube before being tested. In some instances, other type of specimens with higher viral load may be collected and tested, e.g., sputum or saliva.
In some instances, the liquid solvent may contain a mixture of chloroform and methanol (e.g., 2:1, v/v) or another mixture with different types of solvents. In some instances, the liquid solvent may be used to extract various fatty acids including palmitic acid, oleic acid, and linoleic acid, and glycerophospholipids in the virus envelope and host cellular membranes including phosphatidylethanolamine (PE), phosphatidylserine (PS), phosphatidylinositol (PI) and phosphatidylglycerol (PG) species from the specimen. In some instances, the extraction may be performed in a vial, and after extraction, an analyte is formed in the vial for analysis. In some instances, one or more sample pre-processing steps, e.g., pre-concentration, may be further performed after the extraction. In some instances, liquid and protein standards with known concentrations are also prepared for analysis. In some instances, specimens from healthy individuals may be also collected as control samples for comparison. In some examples, SARS-CoV-2 virus (strain 2019nCoV/USAWA1/2020) may be heat-inactivated and obtained from the American Type Culture Collection (ATCC) and the Biodefense and Emerging Infections Research Resources Repository (BEI Resources) under research exemption and biosafety committee approvals. In some instances, non-invasive respiratory specimens may be obtained from research institutions or biorepository companies. In some instances, positive and negative control samples may be developed using lipid standards identified as markers for the SARS-CoV-2 virus and control samples, respectively, and spiked into a synthetic nasopharyngeal (NP) matrix or in another manner. In some instances, inactivated SARS-CoV-2 viruses may be spiked into clinical matrix for determining the Assay Limit of Detection using qPCR as a gold standard. In some instances, the inactivated SARS-CoV-2 viruses spiked into clinical matrix may be also used for determining analytical sensitivity. In some instances, the detection targets characterized by mass spectrometer may be spiked into clinical matrix as control samples.
At 404, the specimen is transferred onto a sample substrate. In some examples, the suspended viruses/host cells and the extracted molecules from the specimen may be deposited by dropping a fixed volume of the specimen in the liquid solvent on the sample surface followed by drying in air at room temperature. In some instances, the sample substrate is a 24-well Polytetrafluoroethylene (PTFE)-coated glass slide or another type of substrate or container.
At 406, a liquid solvent is supplied. In some implementations, the liquid solvent may be supplied to the sample surface to extract (e.g., dissolve or otherwise mix with) the specimen. In some implementations, the sample surface may be implemented as the sample surface 320 as shown in
At 408, an analyte is formed. In some implementations, the liquid solvent after being delivered to the internal reservoir of the sampling device may interact with at least a portion of the specimen at the sample surface causing the molecules to be extracted and dissolved in (or otherwise mix with) the liquid solvent contained in the internal reservoir. In some implementations, the liquid solvent may be allowed to interact with the viruses/host cells and the extracted molecules on the sample surface for a certain time period. In some implementations, the time period may be determined by one or more of the type of the liquid solvent (e.g., polar or non-polar), temperature, and solubility of the species in a solvent.
At 410, the analyte is extracted. In some implementations, the analyte may include the liquid solvent mixed with the specimen. In some implementations, extraction of the analyte from the sample surface may be performed by applying a pressure on one end of a transfer tube coupled to the sampling device. In some instances, the pressure may be lower than the atmospheric pressure. In some implementations, the analyte may be extracted into and analyzed by a mass spectrometer. In certain examples, prior to being analyzed by the mass spectrometer, the analyte may be ionized using an electrospray ionization or another manner. In some instances, the mass spectrometer of the swab sample analysis system include an Orbitrap QE Mass Spectrometer operating under a negative ion mode with a resolving power: 120,000 and a mass accuracy <5 ppm. In some instances, the mass spectrometer may be operated under a positive ion mode to increase chemical coverage, e.g., SARS-CoV-2 nucleocapsid proteins, and predictive strength. In certain examples, other solvent systems to extract a wider range of metabolites and proteins may be used in combination with the mass spectrometer operating under different ion mode.
In some implementations, the mass spectral data may be imported into a commercial statistical analysis software, e.g., RStudio. In some instances, after importing, the mass spectrometry data may be binned to m/z=0.01, and normalized to a total ion current. In some instances, background including molecular features originating from the liquid solvent may be subtracted from the mass spectrometry data. In some implementations, a principle component analysis is performed on the processed mass spectral data and results including classification can be returned. For example, a prcomp function in RStudio is used. In some implementations, limit of detection may be determined by performing the example process 400 on various heat-inactivated SARS-CoV-2 virus samples (e.g., 500 viral copies) and/or titer information from clinical samples. In some instances, molecular features in mass spectra obtained from samples collected from coronavirus-positive patients may be associated with their clinical outcome, including asymptomatic, mild (recovery at home), moderate (non-ICU hospitalization), and severe (ICU hospitalization) clinical course. In some instances, robust predictive models can be constructed to accurately diagnose the coronavirus disease and other related pathogens, and to identify novel predictive markers of the disease and of host response. Reproducibility, accuracy, analytical reactivity, and analytical specificity for high priority pathogens and organisms spiked into controls, and for clinical samples may be evaluated.
In some instances, lipids with m/z values in a range of 600 and 1000 are the major molecular components of the viral envelope structure and are involved in key steps in their replication cycle. Although viruses bud from and acquire all lipids from different parts of their host membranes, viral lipid composition is specific to virus strains, and quantitatively distinct from the host membranes lipid composition. Viral lipid composition varies primarily based on budding site; the SARS-CoV-2 virus, for example, bud from the membrane of the host intermediate pre-Golgi compartment. In a study by Van Genderen et al (Biochem. Soc. Trans., 1995, 23 (3): 523-526), the viral envelope of the coronavirus murine hepatitis virus (MHV) shows a greater proportion of sphingomyelins, PS, and PI than the host cells, and a reduced proportion of PE. The proportion of PI in the viral membranes of MHV is increased by 4% from host cells and the proportion of PS/PI species is reduced by 12%. In some instances, lipid variation is also induced in the infected host cells, as viral pathogens remodel host lipid metabolism to enable replication. In a study by Yan et al (Viruses. 2019; 11(1). pii: E73), fatty acids and glycerophospholipids (e.g., lysoPC and lysoPE) are significantly increased in the human SARS-CoV-2 virus infected cells compared to healthy cells. In some implementations, dysregulation of highly abundant glycerophospholipids in infected host cells and the unique lipid composition of the pathogen itself may represent a promising detection target for diagnostic tests. In some instances, the methods and systems described here can provide high sensitivity and selectivity for untargeted chemical analysis of endogenous compounds such as metabolites, lipids, and proteins from pathogen/host with minimal sample preparation requirements. Using a tandem MS, various lipid markers as well as virus-specific proteins (e.g., SARS-CoV-2 nucleocapsid, N-protein) can be detected and identified. In some instances, host biomarkers can be detected which can potentially provide information on treatment option and prognosis.
As shown in a cross-sectional view of the tip portion 602 in
In some cases, the liquid supply channel 612 may be implemented as the liquid supply channel 312 as shown in
At 702, a swab sample (e.g., a tip or portion of the swab containing the swab sample) is inserted into a tip portion of a sampling device. In some instances, the inserted swab sample contains a specimen collected from a patient. In some instances, the specimen may be collected using a nasal swab, nasopharyngeal swab, oropharyngeal swab, throat swab, or another type of swab. In some instances, swab samples may be categorized into four groups associated with four clinical courses, e.g., asymptomatic, mild, moderate, and severe. In some instances, other type of specimens with higher viral load may be collected and tested, e.g., sputum. In some instances, the swab head may be inserted into an internal reservoir of the tip portion. In some instances, after inserting the swab head into the tip portion through the opening, the tip portion may be sealed by a sealing element associated with the opening such as an O-ring, a membrane, or another type of sealing element such that when the tip portion is inserted into the internal reservoir, the internal reservoir can hold the liquid solvent in direct contact with the swab head without leaking.
At 704, a liquid solvent is supplied. In some implementations, the liquid solvent may be supplied to the swab head of the swab sample in the internal reservoir of the sampling device to mix material from the swab sample with the liquid solvent, e.g., to suspend viruses and/or host cells, and to extract molecules from the swab head. In some implementations, the liquid solvent is supplied to the internal reservoir with controlled volume and flow rate. In some implementations, a control system (e.g., the control system 204 as shown in
At 706, an analyte is formed. In some implementations, the liquid solvent after being delivered to the internal reservoir of the sampling device may interact with at least a portion of the specimen in the swab sample and form the analyte in the internal reservoir. In some instances, the analyte may include one or more of the following: pathogen molecules, molecules from cells of the host and molecules in secretions produced by the cells of the host. In some implementations, the liquid solvent may be allowed to interact with the swab head for a certain time period. In some implementations, the time period may be determined by one or more of a type of solvent (e.g., polar or non-polar) and temperature. In some instances, the analyte may be formed in the internal reservoir after the time period.
At 708, the analyte is extracted. In some implementations, the extraction of the analyte from the internal reservoir may be performed by applying a pressure on one end of a transfer tube coupled to the sampling device. In some instances, the pressure may be lower than the atmospheric pressure. In some implementations, the analyte may be extracted into and analyzed by a mass spectrometer of the swab sample analysis system. In certain examples, prior to being analyzed by the mass spectrometer, the analyte may be ionized using an electrospray ionization or in another manner. In some instances, the mass spectrometer of the swab sample analysis system includes an Orbitrap QE Mass Spectrometer operating under negative ion mode with a resolving power: 140,000 and a mass accuracy <5 ppm. In some instances, after extraction, all the channels and the internal reservoir in the probe device and the transfer tubes attached to the sampling device may be thoroughly flushed one or more times with a cleaning solvent following a washing procedure, or discarded to avoid potential contaminations.
In some implementations, the mass spectrometry data obtained by the mass spectrometer may be imported into a commercial statistical analysis software, e.g., RStudio. In some instances, after importing, the mass spectral data may be binned to m/z=0.01, and normalized to a total ion current. In some instances, background including molecular features originating from the liquid solvent may be subtracted from the mass spectrometry data. In some implementations, a principle component analysis is performed on the processed mass spectrometry data and results including classification can be returned. For example, a prcomp function in RStudio may be used. In some instances, multiple samples (e.g., n=200) including samples with other pathogens and microorganisms may be collected and used to evaluate specificity. In some instances, intra- and inter-sample experiments with control samples/medical swabs may be performed, e.g., n=20/prototype.
In some instances, molecular features in mass spectra obtained from samples collected from coronavirus-positive patients may be associated with their clinical outcome, including asymptomatic, mild (recovery at home), moderate (non-ICU hospitalization), and severe (ICU hospitalization) clinical course. In some instances, the statistical classification model may be employed to build the four-class statistical classifier using the mass spectrometry data obtained from the swab samples. In some instances, performance of the statistical classification model is assessed using cross-validation by evaluating re-call for each class (e.g., an accuracy of greater than 85%). Predictive markers may be identified using tandem MS and high mass accuracy measurements. In some instances, host molecular markers including lipids and metabolites that are indicative of clinical course for the coronavirus-positive patients may be identified. In some instances, robust predictive models can be constructed to accurately diagnose the coronavirus disease and other related pathogens, and to identify novel predictive markers of the disease and of host response.
In some instances, the system and method may have a reproducibility with a relative standard deviation (RSD) of less than 5%, a sensitivity with a total ion count greater than 1×105 and a signal-to-noise ratio (S/N) greater than 10 for molecular analysis, and a total analysis time of less than 30 seconds. In some instances, the system and method may have a sensitivity of greater than 95%, a false-positive rate of less than 5%, a selectivity of greater than 80%, a false-negative rate of less than 20%, and an accuracy of greater than 90%.
As shown in
As shown in
In some instances, the liquid supply port 906 and the liquid extraction port 908 are configured to provide fluidic communication with a control system and a mass spectrometer through respective transfer tubes. In some implementations, the sampling cartridge 900 may be composed of biologically compatible synthetic polymers. In some implementations, the sampling cartridge 900 may be fabricated using a 3D printing process, a machining process, or another type of fabrication process. In some instances, the swab port 904 in a test unit 902 can receive a swab head sample which can be held in place in the internal reservoir 910.
In some aspects of operation, the liquid supply channel 912 in a test unit 902 receives the liquid solvent from an external container, guides the liquid solvent to the internal reservoir 910, where the liquid solvent may be in direct contact with the swab head sample, and fills at least a portion of the internal reservoir 910 with the liquid solvent. In some implementations, the liquid solvent may be received from the external container as a part of a control system, e.g., the control system 204 as shown in
In some implementations, the internal reservoir 910 in a test unit 902 may have a cylindrical shape and be coupled to the liquid supply channels 912. In certain examples, the liquid solvent received from the liquid supply channel 912 in the internal reservoir 910 makes direct contact with the swab head sample inserted from the swab port 904 and at least a portion of the specimen on the swab head sample is extracted into the liquid solvent. In some instances, dimensions of the internal reservoir 904 is designed to receive the entire swab head for maximal molecular extraction.
In some instances, the liquid extraction channel 914 in a test unit 902 obtains an analyte by extracting at least a portion of liquid solvent carrying extracted molecules from the internal reservoir 910, and guides the analyte to the transfer tube that is coupled to a mass spectrometer. In some implementations, the analyte from the internal reservoir 910 may be extracted by a vacuum pump coupled to the mass spectrometer. In some implementations, a low pressure created on one end of the transfer tube may facilitate liquid aspiration to drive the analyte from the internal reservoir 910 to the mass spectrometer through the liquid extraction channel 914.
During operation, one or more swab samples can be simultaneously loaded to the test units 902 on the sampling cartridge 900 and inserted into the internal reservoirs 910 of the test units 902. In some instances, the swab samples are analyzed following a pre-programmed sequence. For example, a first internal reservoir 910A of a first test unit 902A may be filled with a liquid solvent (e.g., a mixture of chloroform and ethanol); the first internal reservoir 910A stays filled for 3-10 seconds or another time period for suspension of viruses/host cells and extraction of molecules from the viruses/host cells from the swab sample; and a first analyte from the first test unit 902A may be transferred to a mass spectrometer for analysis. In some implementations, the time period may be determined by one or more of a type of solvent (e.g., polar or non-polar) and temperature. In some examples, the cartridge 900 can be used to reduce lag time between switching samples, to perform uninterrupted sample analysis, and to improve the screening throughput of the swab sample analysis system. For example, when the first analyte is being transferred to the mass spectrometer, the liquid solvent can be delivered simultaneously to a second internal reservoir 910B of a second test unit 902B. In some instances, assuming testing of a swab sample takes about 30 seconds, testing and screening 10 swab samples using a sampling cartridge 900 with 10 test units 902 can be completed in 5 minutes.
In the example shown in
In some implementations, the ionization system 1008 may include an electrospray ionization source or another ionization source. In some examples, the ionization system 1008 may include a transfer capillary with one end enclosed in an chamber and with the other end directly coupled to the sampling device 1004 via a transfer tube. In some instances, a valve may be coupled on the transfer tube or the transfer capillary to control the flow of an analyte. In some implementations, the valve may be controlled by the control system 1006. In some examples, the chamber can be coupled to a vacuum pump, which can be used to create a low pressure in the chamber. In certain examples, the chamber may be integrated to the mass spectrometer and the low pressure in the chamber may be created by a vacuum system of the mass spectrometer or in another manner. In some implementations, the low pressure may facilitate the extraction of the analyte from the sampling device 1004 to the chamber. A discharge voltage (e.g., up to a few kilovolt) can be applied on the transfer capillary to obtain an ionized analyte. The ionized analyte containing a gas cluster of ionization products of the liquid solvent and dissolved chemical compounds from the sample 1012 can be delivered to the mass spectrometer 1010 for analysis. In some examples, the ionization system 1008 may be implemented as the example ionization system 1200 as shown in
In some implementations, the ionization system 1106 may include an electrospray ionization (ESI) source or another ionization source. In some instances, the ionization system 1106, which may be implemented as the example ionization system 1200 shown in
As shown in
As shown in
The electrospray ionization system 1106 includes a heating element attached to the transfer capillary. The heating element can heat at least a portion of the transfer capillary and thus the analyte in the transfer capillary. The analyte upon being heated can be vaporized. In some instances, the transfer capillary is electrically conductive. A discharge voltage is applied on the conductive transfer capillary and the analyte can be ionized. The ionized analyte can be aspirated into the chamber of the electrospray ionization system 1106 through a tip of the transfer capillary in the chamber. The mass spectrometer includes an inlet tube residing in proximity to the tip of the transfer capillary in the chamber. A low pressure can be applied on the inlet tube to extract the ionized analyte into the mass spectrometer. In some instances, a gas sheath can be formed around at least a portion of the transfer capillary, for example through a coupler (e.g., the example coupler 1300 shown in
As shown in
In some examples, the support block 1214 in the ionization source includes an insulating material (e.g., ceramic) and can be used to provide mechanical support to the transfer capillary 1202 and the coupler 1212. In certain instances, the support block 1214 allows the transfer capillary 1202 and the coupler 1212 to be structurally integrated with the chamber 1204. For example, the support block 1214 can be retrofitted and fused to one end of the heating element 1216. As shown in
In some implementations, the chamber 1204 is integrated to the mass spectrometer and aligned with the inlet tube 1220 and forms a vacuum seal against the housing of the mass spectrometer using an O-ring 1226. In some implementations, a vacuum pump may be coupled at a vacuum port 1218 on the chamber 1204. The vacuum pump can be used to create a low pressure in the chamber 1204. In some implementations, aspiration of an analyte from the sampling device to the chamber 1204 across the transfer capillary 1202 may be facilitated by the low pressure created in the chamber 1204.
In some implementations, the transfer capillary 1202 includes an electrically conductive tube, for example, a 316 stainless-steel tube. In some implementations, the chamber 1204 may include metal, e.g., aluminum (Al) As shown in
In some implementation, the second end 1203B of the transfer capillary 1202 may be configure in proximity to the inlet tube 1220. For example, the second end 1203B of the transfer capillary 1202 and the inlet tube 1220 of the mass spectrometer are closely arranged and separated by a distance (e.g., a few millimeters to centimeters) so that the ionized analyte after forming can be transfer out to the mass spectrometer through the inlet tube 1220. In some implementations, the ions can be captured and analyzed by the mass analyzer within the mass spectrometer, e.g. an orbitrap mass analyzer or an ion trap mass analyzer. In some implementations, prior to the mass analyzer, the ionized analyte may be collected and transferred through ion optic systems (e.g., ion guides such as an 5-lens, or a quadrupole/hexapole). In some instances, the ion optic system may be configured to filter neutral species in the ionized analyte and allow ions passing through. In some instances, the ion optic system may be used to eliminate contamination of the mass spectrometer.
As shown in the example ionization source 1300, the coupler 1310, which is a T-shaped gas fitting, has three ports, e.g., a first port 1312A, a second port 1312B and a third port 1312C. In some example, the coupler 1310 is made of plastic, insulating polymers, rubber, ceramic, or another insulating material. The gas tube 1308 is fluidically coupled between the first port 1312A and a gas container to deliver carrier gas to the first port 1312A. In some instances, the carrier gas received from the first port 1312A may include inert or non-reactive gas such as nitrogen, argon, helium. The transfer capillary 1302 is organized across the second and third ports 1312B and 1312C. As shown in
During operation, the carrier gas, after entering the first port 1312A of the coupler 1310, flows through the body of the coupler 1310 and enters an opening 1320 located inside of the coupler 1310 defined by the ceramic tube 1306 and the transfer capillary 1302. The carrier gas then flows through the spacing between the outer wall of the transfer capillary 1302 and the inner wall of the ceramic tube 1306 and exits on the opposite end of the ceramic tube 1306 located in approximation to the second end 1304B of the transfer capillary 1302. A gas stream 1322 inside the ceramic tube 1306 forms a coaxial gas sheath around the transfer capillary 1302 and flows into the chamber. In some examples, an analyte may be extracted from a sampling device in contact with a swab sample to the first end 1304A, across the transfer capillary 1302, and further to the second 1304B. The analyte aspirated out of the second end 1304B into the chamber can be ionized generating an ionized analyte. In some instances, the coaxial sheath gas exiting the end of the ceramic tube 1306 may be used to evaporate droplets of the extracted and ionized analyte at the second end 1304B and guide the ionized analyte from the second end 1304B of the transfer capillary 1302, for example toward the inlet tube 1220 of the mass spectrometer.
At 1402, a swab sample (e.g., a tip or portion of the swab containing the swab sample) is inserted into a sampling device. In some implementations, the operation 1402 may be implemented with respect to the operation 702 shown in the example process 700. At 1404, a liquid solvent is supplied, and an analyte is formed. In some implementations, a control system (e.g., the control system 1006 as shown in
At 1406, the analyte is extracted. In some implementations, the analyte may be extracted and transported by operation of an ionization system. In some implementations, the transportation of the analyte from the internal reservoir of the sampling device may be performed by applying a pressure on one end of a transfer tube coupled to the sampling device. In some instances, the pressure lower than the atmospheric pressure may be provided by an chamber of the ionization system. For example, the chamber may be under vacuum. In some examples, the analyte may be transported to an electrospray ionization source and sprayed from one end of a transfer capillary to the chamber. The ionization system may be implemented as the ionization system 1200 in
At 1408, an ionized analyte is obtained. In some implementations, the analyte extracted and sprayed into the ionization system may be ionized. In some examples, the ionization process may be operated under a pressure a range of 0.1-2 mbar, or another pressure. In some implementations, the ionized analyte may be obtained in the chamber by applying a discharge voltage on the transfer capillary. In some implementations, the ionized analyte may contain a gas cluster of ionization products of the liquid solvent and the dissolved chemical compound extracted from the swab sample. The ionized analyte may be evaporated and guided to an inlet tube of the mass spectrometer by a coaxial sheath gas created by the ionization source.
At 1410, the ionized analyte is processed. In some implementations, the ionized analyte may be collected and analyzed by a mass spectrometer, e.g., the mass spectrometer 1108 of the example system 1100. In some implementations, the operations 1404, 1406, 1408 and 1410 may be repeatedly performed on the same swab sample or different swab samples. At 1412, data is analyzed. In some instances, the operations 1410 and 1412 may be implemented with respect to the operation 708 of the example process 700 or in another manner.
At 1422 an analyte is formed by supplying a liquid solvent to a tissue sample. In some implementations, a control system (e.g., the control system 1006 as shown in
At 1424, the analyte is transported. At 1426, an ionized analyte is obtained. At 1428, the ionized analyte is processed. At 1430, data is analyzed. In some implementations, the operations 1424, 1426, 1428 and 1430 in the example process 1420 may be implemented with respect to the operations 1406, 1408, 1410 and 1412 shown in the example process 1400.
In some implementations, robustness of the example process 1400 using the example system 1100 can be evaluated. For example, swabs dipped in a standard solution can be used in the evaluation process. In some examples, a standard solution may contain a mixture of lipid standards including 10 micromolar (μM) of PG (m/z=773.535) and 10 μM of PE (m/z=742.540). In some instances, a ratio between the relative abundance values at m/z=773.535 and m/z=742.540 can be determined by analyzing mass spectra collected from multiple measurements (e.g., 10 times). A standard deviation of the ratios was determined as 6.45%, indicating that that the methods and systems presented here can provide reproducible and robust measurements on swab samples.
As shown in
As shown in
25 predictive features, which were selected by the first statistical model, include various lipids. Molecular ion peaks which are selected by the first statistical model that are weighted toward classification of asymptomatic negative are located at m/z=418.24, 460.28, 508.34, 600.51, 618.52, 714.51, 723.98, 750.53, 794.53, 872.64, and 914.58. Molecular ion peaks which are selected by the first statistical model that are weighted toward classification of symptomatic COVID-19 positive are located at m/z=446.34, 512.28, 556.32, 671.6, 682.59, 697.61, 700.59, 734.53, 737.54, 755.56, 757.57, 847.53, 880.52, and 976.62.
Tentatively identified features weighted towards asymptomatic negative include LPE 0-18:3 [M−H]− (m/z 460.28), LPE 20:0 [M−H]− (m/z 508.34), Cer 36:1 [M+Cl]− (m/z 600.51), Cer 36:0 [M+Cl]−(m/z 618.52), PE 34:2 [M−H]−(m/z 714.51), and PS 42:1 [M−H]−(m/z 872.64). Tentatively identified features weighted towards symptomatic COVID-19 positive include LPC 18:1 [M+Cl]−(m/z 556.32), Cer 42:2 [M+Cl]−(m/z 682.59), Cer 44:5 [M+Cl]−(m/z 700.59), PE 34:0 [M−H]−(m/z 734.53), SM 34:1 [M+Cl]−(m/z 737.54), PA 40:1 [M−H]−(m/z 757.57), PA 48:12 [M−H]−(m/z 847.53), and PE 50:9 [M+Cl]−(m/z 976.62).
In some implementations, the statistical weights of the respective molecular ion peaks that are indicative of different samples may have different signs in the statistical model. For example, the statistical weights with negative values are indicative of asymptomatic negative and the statistical weights with positive values are indicative of symptomatic COVID-19 positive. In some implementations, the statistical weights may be configured in another manner according to the statistical model. The methods and systems presented here can be used for differentiating asymptomatic negative samples and symptomatic COVID-19 positive samples, or another application.
As shown in
51 predictive features, which were selected by the second statistical model, include various lipids. Molecular ion peaks which are selected by the second statistical model that are weighted toward classification of negative are located at m/z=418.24, 422, 508.34, 509.34, 538.25, 600.32, 606.49, 612.39, 618.52, 619.29, 624.52, 652.48, 683.59, 714.51, 718.61, 723.98, 724.49, 725.53, 750.53, 769.54, 794.51, 795.53, 840.53, 869.57, and 870.62. Molecular ion peaks which are selected by the second statistical model that are weighted toward classification of symptomatic COVID-19 positive are located at m/z=446.34, 450.87, 506.32, 512.28, 522.28, 556.32, 629.49, 635.48, 671.6, 682.53, 682.57, 684.59, 694.59, 697.61, 703.51, 703.6, 710.62, 734.53, 754.55, 773.53, 776.56, 808.5, 858.72, 880.52, 914.59, and 976.62.
Tentatively identified features weighted towards negative include LPE 20:0 [M−H]− (m/z 508.34), LPE 0-26:7 [M+Cl]− (m/z 600.32), LPI 20:4 [M−H]− (m/z 619.29), PE 34:2 [M−H]− (m/z 714.51), CL 72:7 [M−2H]2−(m/z 724.49), DG 42:7 [M−H]− (m/z 725.53), PE 36:2 [M+Cl]− (m/z 794.51), and PC 38:6 [M+Cl]− (m/z 840.53). Tentatively identified features weighted towards symptomatic COVID-19 positive include LPE 20:1 [M−H]− (m/z 506.32), LPS 18:1 [M−H]− (m/z 522.28), LPC 18:1 [M+Cl]− (m/z 556.32), DG 34:1 [M+Cl]−(m/z 629.49), DG 0-36:5 [M+Cl]− (m/z 635.48), Cer 43:3 [M+Cl]− (m/z 694.59), DG 40:6 [M+Cl]− (m/z 703.51), Cer 44:2 [M+Cl]− (m/z 710.62), PE 34:0 [M−H]− (m/z 734.53), PC 0-32:0 [M+Cl]− (m/z 754.55), PG 36:2 [M−H]− (m/z 773.53), PE 0-40:6 [M−H]− (m/z 776.56), PE 0-40:8 [M+Cl]− (m/z 808.5), and PE 50:9 [M+Cl]− (m/z 976.62).
In some implementations, the statistical weights of the respective molecular ion peaks that are indicative of different samples may have different signs in the statistical model. For example, the statistical weights with negative values are indicative of negative and the statistical weights with positive values are indicative of symptomatic COVID-19 positive. In some implementations, the statistical weights may be configured in another manner according to the second statistical model. The methods and systems presented here can be used for differentiating negative samples and symptomatic COVID-19 positive samples, or another application.
As shown in
20 predictive features, which were selected by the third statistical model, include various lipids. Molecular ion peaks which are selected by the third statistical model that are weighted toward classification of symptomatic negative are located at m/z=417.24, 436.28, 452.28, 465.3, 588.48, 626.54, 680.58, 682.59, 683.59, and 794.55. Molecular ion peaks which are selected by the third statistical model that are weighted toward classification of symptomatic COVID-19 positive are located at m/z=446.34, 450.87, 530.3, 572.48, 576.57, 629.49, 750.54, 754.55, 820.56, and 885.55.
Tentatively identified features weighted towards symptomatic negative include LPA 0-18:3 [M−H]− (m/z 417.24), LPE 0-16:1 [M−H]− (m/z 436.28), LPE 16:0 [M−H]− (m/z 452.28), Cholesterol Ester [M−H]− (m/z 465.3), Cer 34:1 [M+Cl]− (m/z 588.48), Cer 42:3 [M+Cl]− (m/z 680.58), Cer 42:2 [M+Cl]− (m/z 682.59), and PC 34:1 [M+Cl]− (m/z 794.55). Tentatively identified features weighted towards symptomatic COVID-19 positive include LPC 16:0 [M+Cl]− (m/z 530.3), Cer 34:1 [M+Cl]− (m/z 572.48), DG 34:1 [M+Cl]− (m/z 629.49), PE 0-38:5 [M−H]− (m/z 750.54), PC 0-32:0 [M+Cl]− (m/z 754.55), PC 36:2 [M+Cl]− (m/z 820.56), and PI 38:4 [M−H]− (m/z 885.55).
In some implementations, the statistical weights of the respective molecular ion peaks that are indicative of different samples may have different signs in the statistical model. For example, the statistical weights with negative values are indicative of symptomatic negative and the statistical weights with positive values are indicative of symptomatic COVID-19 positive. In some implementations, the statistical weights may be configured in another manner according to the third statistical model. The methods and systems presented here can be used for differentiating symptomatic negative samples and symptomatic COVID-19 positive samples, or another application.
Some of the subject matter and operations described in this specification can be implemented in digital electronic circuitry, or in computer software, firmware, or hardware, including the structures disclosed in this specification and their structural equivalents, or in combinations of one or more of them. Some of the subject matter described in this specification can be implemented as one or more computer programs, i.e., one or more modules of computer program instructions, encoded on a computer storage medium for execution by, or to control the operation of, data-processing apparatus. A computer storage medium can be, or can be included in, a computer-readable storage device, a computer-readable storage substrate, a random or serial access memory array or device, or a combination of one or more of them. Moreover, while a computer storage medium is not a propagated signal, a computer storage medium can be a source or destination of computer program instructions encoded in an artificially generated propagated signal. The computer storage medium can also be, or be included in, one or more separate physical components or media.
Some of the operations described in this specification can be implemented as operations performed by a data processing apparatus on data stored on one or more computer-readable storage devices or received from other sources.
The term “data-processing apparatus” encompasses all kinds of apparatus, devices, and machines for processing data, including by way of example a programmable processor, a computer, a system on a chip, or multiple ones, or combinations, of the foregoing. The apparatus can include special purpose logic circuitry, e.g., an Arduino board, an FPGA (field programmable gate array) or an ASIC (application specific integrated circuit). The apparatus can also include, in addition to hardware, code that creates an execution environment for the computer program in question, e.g., code that constitutes processor firmware, a protocol stack, a database management system, an operating system, a cross-platform runtime environment, a virtual machine, or a combination of one or more of them.
A computer program (also known as a program, software, software application, script, or code) can be written in any form of programming language, including compiled or interpreted languages, declarative or procedural languages, and it can be deployed in any form, including as a stand-alone program or as a module, component, subroutine, object, or other unit suitable for use in a computing environment. A computer program may, but need not, correspond to a file in a file system. A program can be stored in a portion of a file that holds other programs or data (e.g., one or more scripts stored in a markup language document), in a single file dedicated to the program, or in multiple coordinated files (e.g., files that store one or more modules, sub programs, or portions of code). A computer program can be deployed to be executed on one computer or on multiple computers that are located at one site or distributed across multiple sites and interconnected by a communication network.
Some of the processes and logic flows described in this specification can be performed by one or more programmable processors executing one or more computer programs to perform actions by operating on input data and generating output. The processes and logic flows can also be performed by, and apparatus can also be implemented as, special purpose logic circuitry, e.g., an FPGA (field programmable gate array) or an ASIC (application specific integrated circuit).
In a general aspect of what is described above, a swab sample is analyzed, for example, to test for a disease.
In a first example, an analyte is formed by mixing material from a swab sample with a solvent, and the analyze is provided to a mass spectrometer. The mass spectrometer processes the analyte to generate mass spectrometry data. The mass spectrometry data is analyzed to identify a disease marker.
Implementations of the first example may include one or more of the following features. The swab sample (e.g., the swab head containing material extracted from a subject) may be inserted into a reservoir, and the swab sample can be in direct contact with the liquid solvent and interact with the liquid solvent for a certain period of time. A specimen can be extracted from the swab head of the swab sample to form the analyte in the reservoir. The reservoir can be a reservoir in a sampling device that includes only a single reservoir, a reservoir in a cartridge that contains many such reservoirs, or a reservoir in another type of device.
Implementations of the first example may include one or more of the following features. Identifying a disease marker may include identifying a marker of whooping cough, diphtheria, influenza, a disease (e.g., SARS, MERS, or COVID-19) caused by the coronavirus family of viruses, strep throat, pneumonia, and tonsillitis. A determination of whether the disease marker is present can be used to provide a diagnosis, for example, to diagnose COVID-19 or another type of disease.
In a second example, a liquid solvent is supplied to a swab head via a first channel of a sampling device by operation of a control system. The liquid solvent interacts with the swab head to form an analyte in an internal reservoir. The analyte is transferred from the internal reservoir via a second channel of the sampling device to a mass spectrometer. The mass spectrometer performs analysis on the analyte to produce mass spectrometry data. The mass spectrometry data are analyzed to detect (e.g., to detect the presence of, or a level of) a virus (e.g., SARS-CoV-2 virus) in the analyte. The virus may be detected and identified, for example, using the mass spectrometry data and a statistical classification model for diagnosing the coronavirus disease.
Implementations of the second example may include one or more of the following features. The swab head is inserted into the internal reservoir through an opening on the sampling device. The sampling device includes a gas channel that can communicate gas (e.g., air) to the internal reservoir. The internal reservoir interfaces with the swab head, and the liquid solvent in the internal reservoir contacts the swab head. The swab head can include a sample that may or may not contain a disease marker (e.g., a marker of the SARS-CoV-2 virus), and the mass spectrometry data may be analyzed to detect the disease marker. The analysis may include detecting and identifying the disease marker for SARS-CoV-2 virus or another disease. The swab head may include a specimen collected from a swabbing procedure. The liquid solvent may include a mixture of chloroform and ethanol. The statistical classification model can be trained based on molecular features in mass spectrometry data generated by the mass spectrometer to diagnose the coronavirus disease.
In a third example, a liquid solvent is supplied to a swab head via a first channel of a sampling device by operation of a control system. The liquid solvent interacts with the swab head to form an analyte in an internal reservoir. The analyte is transferred from the internal reservoir via a second channel of the sampling device to an ionization system to form an ionized analyte. The ionized analyte is transferred to a mass spectrometer. The mass spectrometer performs analysis on the analyte to produce mass spectrometry data. The mass spectrometry data are analyzed to detect (e.g., to detect the presence of, or a level of) a virus (e.g., SARS-CoV-2 virus) in the analyte. The virus may be detected and identified, for example, using the mass spectrometry data and a statistical classification model for diagnosing the coronavirus disease.
Implementations of the third example may include one or more of the following features. The ionization system includes an electrospray ionization source. The electrospray ionization source includes a transfer capillary and can be integrated with an chamber. The transfer capillary is fluidically coupled with the sampling device to guide the analyte from the internal reservoir of the sampling device to the chamber. The chamber is under vacuum. The electrospray ionization source includes an insulating tube coaxially arranged outside a portion of the transfer capillary. The electrospray ionization source is configured to form a coaxial sheath gas between an inner wall of the insulating tube and the outer wall of the transfer capillary.
In a general aspect of what is described above, a tissue sample is analyzed, for example, to identify molecules that are present in the tissue sample.
In a fourth example, an analyte is formed by supplying a solvent to a tissue sample. An ionization system transports the analyte to an chamber under vacuum through an electrospray ionization source. The electrospray ionization source generates an ionized analyte in the chamber. A mass spectrometer processes the ionized analyte to generate mass spectrometry data.
In a fifth example, a swab head of a swab sample is inserted through an opening into an internal reservoir of a sampling device. The sampling device includes the opening, an inlet channel, an outlet channel, and the internal reservoir. The internal reservoir is in fluid communication with the inlet channel, the outlet channel, and the opening. A liquid solvent is supplied to the swab head in the internal reservoir via the inlet channel of the sampling device. The swab head is held in the liquid solvent for a period of time to form an analyte in the internal reservoir. The analyte is extracted from the internal reservoir via the outlet channel of the sampling device. The analyte is transferred to a mass spectrometer. The analyte is processed, to obtain mass spectrometry data by operation of the mass spectrometer.
Implementations of the fifth example may include one or more of the following features. Prior to inserting the swab head of the swab sample through the opening into the internal reservoir of the sampling device, a specimen from a target region of a subject is collected by inserting a clean swab into the target region. The sampling device includes a sealing element at the opening. The opening resides on a first end of a tip portion of the sampling device. After inserting the swab head of the swab sample through the opening into the internal reservoir, the opening at the tip portion is sealed by the sealing element. The liquid solvent includes sterile water. When the liquid solvent is supplied to the swab head, the sterile water is supplied to the internal reservoir; and at least a portion of the internal reservoir is filled up to allow the sterile water to interact with at least a portion of the swab head.
Implementations of the fifth example may include one or more of the following features. When the analyte is processed to obtain the mass spectrometry data, the analyte is received at an ionization system; an ionized analyte is obtained by operation of the ionization system; and the ionized analyte is subject to a mass spectrometry analysis. The ionization system includes a chamber and a vacuum source. When the analyte is received at the ionization system, the chamber is evacuated using the vacuum source to create a first pressure in the chamber. The first pressure is less than the atmospheric pressure in an environment of the sampling device. The ionization system is an electrospray ionization source. The ionization system includes a transfer capillary. When the ionized analyte is obtained, the analyte is extracted into a first end of the transfer capillary via the outlet channel; a discharge voltage is applied to a second, opposite end of the transfer capillary to form the ionized analyte, and at least a portion of the transfer capillary is heated. The second, opposite end of the transfer capillary resides in the chamber of the ionization system. The second, opposite end of the transfer capillary in the chamber is positioned in proximity to an inlet tube of the mass spectrometer. The ionization system includes a coupler. A gas flow is received on a first port of the coupler. A coaxial gas sheath is formed around the transfer capillary. The coaxial gas sheath flows from the first port to a second port of the coupler and is configured to guide the ionized analyte from the second, opposite end of the transfer capillary to the inlet tube of the mass spectrometer.
Implementations of the fifth example may include one or more of the following features. The analyte includes a liquid sample collected from the swab head. A mass spectrometry profile of the liquid sample is generated by operation of the mass spectrometer. The swab sample includes a plurality of swab samples. The inlet channel includes a plurality of inlet channels. The outlet channel includes a plurality of outlet channels. The opening includes a plurality of openings. Respective swab samples are inserted into respective internal reservoirs through respective openings. Liquid solvent is supplied to the respective swab samples in the respective internal reservoirs through respective inlet channels. Respective analytes are extracted from the respective internal reservoirs through respective outlet channels. The analytes are transferred to the mass spectrometer and processed to obtain mass spectrometry data. The mass spectrometry data is analyzed to identify whether one or more disease markers are present. When the one or more disease markers are identified, one or more disease markers of COVID-19 are identified.
In a sixth example, a swab sample analysis system includes a container, a mass spectrometer, a sampling device, and a control system. The container includes a liquid solvent. The mass spectrometer is configured to produce mass spectrometry data by processing an analyte. The sampling device includes an opening; an internal reservoir configured to receive a swab head inserted into the sampling device through the opening, and to hold the swab head in a fixed volume of the liquid solvent for a period of time to form the analyte in the sampling device; a first channel configured to communicate the liquid solvent into the internal reservoir; and a second channel configured to communicate the analyte from the internal reservoir. The control system is configured to perform operations including: supplying the liquid solvent to the internal reservoir through the first channel of the sampling device; extracting the analyte from the internal reservoir through the second channel of the sampling device; and transferring the analyte to the mass spectrometer.
Implementations of the sixth example may include one or more of the following features. The swab sample analysis system includes an ionization system configured to ionize the analyte, and the operations include transferring the analyte to the ionization system. The ionization system includes a transfer capillary configured to receive the analyte. The ionization system includes a heating element attached to the transfer capillary. The heating element is configured to heat the analyte in the transfer capillary to obtain a vaporized analyte. The ionization system is configured to ionize the vaporized analyte to produce an ionized analyte. The ionization system is an electrospray ionization system including a chamber. When the analyte is transferred to the ionization system, the analyte is sprayed into the chamber of the ionization system through a tip of a transfer capillary.
Implementations of the sixth example may include one or more of the following features. The opening resides on one end of a tip portion of the sampling device. The sampling device includes a sealing element at the opening; and the sealing element is configured to seal the opening after the swab head is inserted into the internal reservoir. The opening resides on one end of the sampling device. When the analyte is extracted from the internal reservoir through the second channel of the sampling device, air is received from an atmosphere of the sampling device to the internal reservoir through the opening. The swab sample analysis system includes one or more computer systems which are configured to analyze the mass spectrometry data to detect a substance present on a swab head. The sampling device includes a gas channel configured to supply gas to the internal reservoir. The one or more computer systems are configured to analyze the mass spectrometry data to identify whether one or more disease markers are present. When the one or more disease markers are identified, one or more disease markers of COVID-19 are identified.
In a seventh example, a system includes an external container, an electrospray ionization system, a mass spectrometer, one or more computer systems, a sampling device, and a control system. The external container includes a liquid solvent. The electrospray ionization system is configured to ionize an analyte. The mass spectrometer is configured to produce mass spectrometry data by processing the ionized analyte provided by the electrospray ionization system. One or more computer systems are configured to analyze the mass spectrometry data to detect a substance present on a sample surface. The sampling device includes an internal reservoir, a first channel, a second channel, and a third channel. The internal reservoir is configured to hold a fixed volume of the liquid solvent in direct contact with the sample surface for a period of time to form the analyte in the sampling device. The first channel is configured to communicate the liquid solvent into the internal reservoir. The second channel is configured to communicate gas into the internal reservoir. The third channel is configured to communicate the analyte from the internal reservoir. The control system is configured to perform operations including: supplying the liquid solvent to the internal reservoir through the first channel of the sampling device; extracting the analyte from the internal reservoir through the third channel of the sampling device; and transferring the analyte to the electrospray ionization system by applying a first pressure in the electrospray ionization system. The first pressure is less than the atmospheric pressure in an environment of the sampling device.
Implementations of the seventh example may include one or more of the following features. The electrospray ionization system includes a transfer capillary configured to receive the analyte. When the analyte is transferred, the analyte is transferred from the internal reservoir to the transfer capillary. The electrospray ionization system includes a heating element attached to the transfer capillary. When the analyte is ionized, the analyte is heated by operation of the heating element in the transfer capillary to obtain a vaporized analyte; and the vaporized analyte is ionized to produce the ionized analyte. The electrospray ionization system includes a chamber. When the analyte is transferred to the electrospray ionization system, the analyte is aspirated into the chamber of the electrospray ionization system through a tip of the transfer capillary. The transfer capillary is electrically conductive. When the analyte is ionized, a discharge voltage is applied on the transfer capillary to obtain the ionized analyte. The electrospray ionization system includes a chamber. The mass spectrometer includes an inlet tube residing in proximity to a tip of the transfer capillary in the chamber. The operations include applying a second pressure on the inlet tube. The second pressure on the inlet tube is less than the first pressure.
Implementations of the seventh example may include one or more of the following features. The electrospray ionization system includes a chamber coupled to a vacuum source. When the first pressure is applied, the chamber is evacuated to the first pressure by operation of the vacuum source. The system includes a first transfer tube and a second transfer tube. The first transfer tube communicates the liquid solvent from the external container to the first channel; and the second transfer tube communicates the analyte from the sampling device to the electrospray ionization system. The second channel includes an open end that receives air from an atmosphere of the sampling device. The fixed volume is defined by the volume of the internal reservoir. The sampling device is a handheld sampling device. The sample surface includes a surface of a biological tissue.
In an eighth example, a liquid solvent is supplied through a first channel of a sampling device to an internal reservoir of the sampling device. A fixed volume of the liquid solvent is held in the internal reservoir in direct contact with a sample surface for a period of time to form an analyte in the sampling device. Gas is supplied to the internal reservoir of the sampling device through a second channel of the sampling device. The analyte is extracted from the internal reservoir through a third channel of the sampling device and transferred to an electrospray ionization system by applying a first pressure in the electrospray ionization system. The first pressure is less than the atmospheric pressure in an environment of the sampling device. By operation of the electrospray ionization system, the analyte from the internal reservoir is ionized. By operation of a mass spectrometer, mass spectrometry data is produced by processing the ionized analyte from the electrospray ionization system. The mass spectrometry data is analyzed to detect a substance present at the sample surface.
Implementations of the eighth example may include one or more of the following features. The electrospray ionization system includes a chamber coupled to a vacuum source. When the first pressure is applied, the chamber is evacuated to the first pressure by operation of the vacuum source. The electrospray ionization system includes a transfer capillary that receives the analyte. When the analyte is transferred, the analyte is transferred from the sampling device to the transfer capillary. When the analyte is ionized, the analyte is heated in the transfer capillary to obtain a vaporized analyte; and the vaporized analyte is ionized to produce the ionized analyte. The electrospray ionization system includes a chamber. When the analyte is transferred to the electrospray ionization system, the analyte is sprayed into the chamber of the electrospray ionization system through a tip of the transfer capillary by forming a gas sheath around at least a portion of the transfer capillary. The transfer capillary is electrically conductive. When the analyte is ionized, a discharge voltage is applied on the transfer capillary to obtain the ionized analyte. The electrospray ionization system includes a chamber. The mass spectrometer includes an inlet tube residing in proximity to a tip of the transfer capillary in the chamber. A second pressure is applied on the inlet tube, wherein the second pressure on the inlet tube is less than the first pressure. The ionized analyte is provided to the mass spectrometer by collecting the ionized analyte through the inlet tube.
Implementations of the eighth example may include one or more of the following features. The first channel receives the liquid solvent from the external container through a first transfer tube. The analyte is transferred from the sampling device to the electrospray ionization system through a second transfer tube. The second channel receives the gas through an open port that receives air from an atmosphere of the sampling device. The fixed volume is defined by the volume of the internal reservoir. The sample surface includes a surface of a biological tissue.
While this specification contains many details, these should not be understood as limitations on the scope of what may be claimed, but rather as descriptions of features specific to particular examples. Certain features that are described in this specification or shown in the drawings in the context of separate implementations can also be combined. Conversely, various features that are described or shown in the context of a single implementation can also be implemented in multiple implementations separately or in any suitable sub-combination.
Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. In certain circumstances, multitasking and parallel processing may be advantageous. Moreover, the separation of various system components in the implementations described above should not be understood as requiring such separation in all implementations, and it should be understood that the described program components and systems can generally be integrated together in a single product or packaged into multiple products.
A number of embodiments have been described. Nevertheless, it will be understood that various modifications can be made. Accordingly, other embodiments are within the scope of the present disclosure.
This application claims priority to U.S. Provisional Patent Application No. 63/017,387, filed Apr. 29, 2020, entitled “Collecting and Analyzing Swab Samples;” and U.S. Provisional Patent Application No. 63/088,724, filed Oct. 7, 2020, entitled “Collecting and Analyzing Swab Samples.” All of the above-referenced priority documents are incorporated herein by reference in their entirety.
Number | Date | Country | |
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63017387 | Apr 2020 | US | |
63088724 | Oct 2020 | US |
Number | Date | Country | |
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Parent | PCT/US2021/029819 | Apr 2021 | US |
Child | 17975104 | US |