Development and evaluation of a rapid detection assay for severe fever with thrombocytopenia syndrome virus based on reverse-transcription recombinase polymerase amplification, Molecular and Cellular Probes (2020), doi: https://doi.Table of Abbreviations: dT-FAM Thymidine nucleotide carrying FAM fluorophore dT-BHQ1 Thymidine nucleotide carrying BHQ-1 quencher HHV Human herpesvirus LAMP loop-mediated isothermal amplification LOD Limit of detection PIV Parainfluenza virus RPA Recombinase polymerase amplification RT-LAMP Reverse-transcription loop-mediated isothermal amplification RT-PCR Reverse-transcription polymerase chain reaction RT-qPCR Real-time reverse-transcription polymerase chain reaction RT-RAA Reverse-transcription recombinase-aided amplification RT-RPA Real-time reverse-transcription recombinase polymerase amplification SFTS Severe fever with thrombocytopenia syndrome SFTSV Severe fever with thrombocytopenia syndrome virus SSB Single-stranded DNA binding Abstract 1 Rapid detection of severe fever with thrombocytopenia syndrome virus (SFTSV) is 2 crucial for its control and surveillance. In this study, a rapid isothermal real-time 3 reverse-transcription recombinase polymerase amplification (RT-RPA) assay was 4 developed for the detection of SFTSV. The detection limit at 95% probability was 241 5 copies per reaction. A test of 120 serum samples of suspected severe fever with 6 thrombocytopenia syndrome (SFTS) patients revealed that the sensitivity and 7 specificity of the RT-RPA assay was approximately 96.00% (95%CI: 80.46%-99.79%) 8 and 98.95% (95% CI: 94.28%-99.95%), respectively; the kappa value was 0.9495 (P 9 <0.001). The Bland-Altman analysis showed that 87.50% of the different data points 10 were located within the 95% limits of agreement, indicating a good correlation 11 between the results from RT-RPA assays and those of RT-qPCR assays. In conclusion, 12 the rapid and efficient RT-RPA assay can be a promising candidate for point-of-care 13 detection method of SFTSV. 14 15 Keywords: Severe fever with thrombocytopenia syndrome virus; Recombinase 16 polymerase amplification; Detection assay Severe fever with thrombocytopenia syndrome virus (SFTSV), belonging to the 19 family Phenuiviridae, the genus Banyangvirus, the species Huaiyangshan 20 banyangvirus, was first identified as the causative pathogen of the outbreak of severe 21 fever with thrombocytopenia syndrome (SFTS) in the central and northeast regions of 22 China in 2009 [1]. During the following decade, this emerging endemic tick-borne 23 disease has been reported in many countries worldwide, including South Korea, Japan, 24 United Arab Emirates, and the United States [2-5]. Delayed admission due to 25 nonspecific clinical manifestations, along with rapid progression to multiple organ 26 dysfunction in severe cases led to a high case fatality rate of 6.40~30% in SFTS 27 patients [6, 7]. 28 Currently, detection methods of SFTSV comprise nucleic acid testing, serological 29 detection, and virus isolation [1, 8, 9]. Due to the long turnaround...