Identification of Hotspot Mutations in the N Gene of SARS-CoV-2 in Russian Clinical Samples That May Affect the Detection by Reverse Transcription-PCR.

Sensitive and reliable diagnostic test systems based on real-time PCR are of great importance in the fight against the ongoing SARS-CoV-2 pandemic. The genetic variability of the SARS-CoV-2 virus leads to the accumulation of mutations, some of which may affect the sensitivity of modern PCR assays. The aim of this study was to search in Russian clinical samples for new mutations in SARS-CoV-2 gene that can affect the detection by RT-PCR. In this study, the polymorphisms in the regions of the target gene causing failed or poor detection of the target in the RT-PCR assay on 12 selected samples were detected. Sequencing the entire and genes in these samples along with other 195 samples that were positive for both target regions was performed. Here, we identified a number of nonsynonymous mutations and one novel deletion in the gene that affected the ability to detect a target in the gene as well a few mutations in the gene of SARS-CoV-2 that did not affect detection. Sequencing revealed that majority of the mutations in the gene were located in the variable region between positions 193 and 235 aa, inside and nearby the phosphorylated serine-rich region of the protein N. This study highlights the importance of the further characterization of the genetic variability and evolution of gene , the most common target for detecting SARS-CoV-2. The use of at least two targets for detecting SARS-CoV-2, including one for the gene, will be necessary for reliable diagnostics.