Fig. 1: Implementation of CARMEN using a microfluidic system improves sensitivity and speed.

a, Schematic of CARMEN v.1 (top) and mCARMEN (bottom) workflows. b, Heatmap showing mCARMEN fluorescent data across 21 human respiratory viruses (synthetic DNA fragments and corresponding viral Cas13 crRNAs) at 1 h post-reaction initiation, which were serially diluted from 103 to 101 copies μl−1 and amplified using 2 separate primer pools. All samples were background-subtracted from the no target control (NTC)-noMg negative control. c, Concordance between CARMEN v.1 and mCARMEN from b. Blue: targets at 103 copies μl−1; green: targets at 102 copies μl−1; red: targets at 101 copies μl−1. d, Fluorescence kinetics of amplified SARS-CoV-2 DNA gene fragments from 104–101 copies μl−1 at 0, 1 and 3 h post-reaction initiation. Blue: mCARMEN; red: CARMEN v.1. e, A 21-human respiratory virus panel was tested on clinical specimens from 6 SARS-CoV-2-positive, 4 SARS-CoV-2-negative nasopharyngeal (NP) swabs and 8 FLUAV-positive specimens, collected before December 2019, and 5 NTCs. The heatmap shows fluorescent signals from SARS-CoV-2 crRNA, FLUAV crRNA and no crRNA control. Blue: mCARMEN at 1 h post-reaction initiation; red: CARMEN v.1 at 3 h post-reaction initiation. f, Concordance of mCARMEN and NGS on 58 suspected respiratory virus-infected patient specimens collected before December 2019 shown as a bar graph; overall concordance is shown as a confusion matrix. Black: detected by both mCARMEN and NGS; blue: detected by mCARMEN only; green: detected by NGS only. mCARMEN values are shown as the normalized fluorescence signal (FAM/ROX) (FAM signal divided by the signal for the passive reference dye, ROX, 1 h). CARMEN v.1 values are shown as the raw fluorescence signal (FAM). NTC-extract: no target control taken through extraction, cDNA synthesis, amplification, and detection; NTC-cDNA: no target control taken through cDNA synthesis, amplification and detection; NTC-amp: no target control taken through amplification and detection; NTC-det: no target control taken through detection; NTC-noMg: no target control expected to have no fluorescent signal due to lack on Mg2+ needed to activate Cas13.