Optofluidic devices combining micro-optical and microfluidic components bring a host of new advantages to conventional microfluidic devices. Aspects, such as optical beam shaping, can be integrated on-chip and provide high-sensitivity and built-in optical alignment. Optofluidic microflow cytometers have been demonstrated in applications, such as point-of-care diagnostics, cellular immunophenotyping, rare cell analysis, genomics and analytical chemistry. Flow control, light guiding and collecting, data collection and data analysis are the four main techniques attributed to the performance of the optofluidic microflow cytometer. Each of the four areas is discussed in detail to show the basic principles and recent developments. 3D microfabrication techniques are discussed in their use to make these novel microfluidic devices, and the integration of the whole system takes advantage of the miniaturization of each sub-system. The combination of these different techniques is a spur to the development of microflow cytometers, and results show the performance of many types of microflow cytometers developed recently.

The rapid detection and quantification of infectious pathogens is an essential component to the control of potentially lethal outbreaks among human populations worldwide. Several of these highly infectious pathogens, such as Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have been cemented in human history as causing epidemics or pandemics due to their lethality and contagiousness. SARS-CoV-2 is an example of these highly infectious pathogens that have recently become one of the leading causes of globally reported deaths, creating one of the worst economic downturns and health crises in the last century. As a result, the necessity for highly accurate and increasingly rapid on-site diagnostic platforms for highly infectious pathogens, such as SARS-CoV-2, has grown dramatically over the last two years. Current conventional non-microfluidic diagnostic techniques have limitations in their effectiveness as on-site devices due to their large turnaround times, operational costs and the need for laboratory equipment. In this review, we first present criteria, both novel and previously determined, as a foundation for the development of effective and viable on-site microfluidic diagnostic platforms for several notable pathogens, including SARS-CoV-2. This list of criteria includes standards that were set out by the WHO, as well as our own “seven pillars” for effective microfluidic integration. We then evaluate the use of microfluidic integration to improve upon currently, and previously, existing platforms for the detection of infectious pathogens. Finally, we discuss a stage-wise means to translate our findings into a fundamental framework towards the development of more effective on-site SARS-CoV-2 microfluidic-integrated platforms that may facilitate future pandemic diagnostic and research endeavors. Through microfluidic integration, many limitations in currently existing infectious pathogen diagnostic platforms can be eliminated or improved upon.

A rapid, sensitive and simple microflow cytometry-based agglutination immunoassay (MCIA) was developed for point-of-care (POC) quantitative detection of SARS-CoV-2 IgM and IgG antibodies. The antibody concentration was determined by using the transit time of beads aggregates. A linear relationship was established between the average transit time and the concentration of SARS-CoV-2 IgM and IgG, respectively. The limit of detection (LOD) of SARS-CoV-2 IgM and IgG by the MCIA measurement are 0.06 mg/L and 0.10 mg/L, respectively. The 10 µL sample consumption, 30 min assay time and the compact setup make this technique suitable for POC quantitative detection of SARS-CoV-2 antibodies.

Gating or threshold selection is very important in analyzing data from a microflow cytometer, which is especially critical in analyzing weak signals from particles/cells with small sizes. It has been reported that using the amplitude gating alone may result in false positive events in analyzing data with a poor signal-to-noise ratio. Transit time (τ) can be set as a gating threshold along with side-scattered light or fluorescent light signals in the detection of particles/cells using a microflow cytometer. In this study, transit time of microspheres was studied systematically when the microspheres passed through a laser beam in a microflow cytometer and side-scattered light was detected. A clear linear relationship between the inverse of the average transit time and total flow rate was found. Transit time was used as another gate (other than the amplitude of side-scattering signals) to distinguish real scattering signals from noise. It was shown that the relative difference of the measured microsphere concentration can be reduced significantly from the range of 3.43%–8.77% to the range of 8.42%–111.76% by employing both amplitude and transit time as gates in analysis of collected scattering data. By using optimized transit time and amplitude gate thresholds, a good correlation with the traditional hemocytometer-based particle counting was achieved (R² > 0.94). The obtained results suggest that the transit time could be used as another gate together with the amplitude gate to improve measurement accuracy of particle/cell concentration for microfluidic devices.

An accurate and rapid microflow cytometry-based agglutination immunoassay (MCIA) suitable for on-site antibody or antigen detection was proposed. In this study, quantitative C-reactive protein (CRP) detection was chosen as a model assay in order to demonstrate the detection principle. The average transit time was employed to estimate the extent of the agglutination reaction and improve the detection accuracy as compared to the intensity-dependent methods. The detection time was less than 8 min. and only a 20 µL serum sample was needed for each test. The results showed a linear relationship between the average transit time of aggregates and CRP concentrations ranging from 0 to 1 µg/mL. The R² of this relationship was 0.99. The detection limit of this technology was 0.12 µg/mL CRP. The system used for CRP detection can be extended to also monitor other clinically relevant molecules.