Diagnosis of COVID-19 by exhaled breath analysis using gas chromatography–mass spectrometry

Abstract

BackgroundThe ongoing COVID-19 pandemic has claimed over two and a half million lives worldwide so far. SARS-CoV-2 infection is perceived to be seasonally recurrent and a rapid non-invasive biomarker to accurately diagnose patients early-on in their disease course will be necessary to meet the operational demands for COVID-19 control in the coming years.ObjectiveTo evaluate the role of exhaled breath volatile biomarkers in identifying patients with suspected or confirmed COVID-19 infection, based on their underlying PCR status and clinical probability.MethodsA prospective, real-world, observational study recruiting adult patients with suspected or confirmed COVID-19 infection. Breath samples were collected using a standard breath collection bag, modified with appropriate filters to comply with local infection control recommendations and samples were analysed using gas chromatography-mass spectrometry (TD-GC-MS).Findings81 patients were recruited between April 29th to July 10th, 2020, of whom 52/81 (64%) tested positive for COVID-19 by RT-PCR. A regression analysis identified a set of seven exhaled breath features (benzaldehyde, 1-propanol, 3, 6-methylundecane, camphene, beta-cubebene, Iodobenzene, and an unidentified compound) that separated PCR positive patients with an area under the curve (AUC): 0.836, sensitivity: 68%, specificity: 85%.ConclusionsGC-MS detected exhaled breath biomarkers were able to identify PCR positive COVID-19 patients. External replication of these compounds is warranted to validate these results.

Breath-Taking Perspectives and Preliminary Data toward Early Detection of Chronic Liver Diseases

“…), who described fetor hepaticus , the musty breath of subjects undergoing liver failure [ 40 ]. The last five decades have seen the evolution of more quantitative and accurate instruments that led to the discovery of a considerable number of breath compounds associated with several diseases [ 41 , 42 , 43 ], including Alzheimer’s [ 44 , 45 ], Parkinson’s [ 44 ], schizophrenia [ 46 , 47 ], multiple sclerosis [ 48 , 49 ], breast cancer [ 50 , 51 ], colorectal cancer [ 51 , 52 , 53 ], lung cancer [ 51 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], asthma [ 61 , 62 , 63 , 64 , 65 ], chronic obstructive pulmonary disease (COPD) [ 61 , 66 , 67 , 68 , 69 , 70 , 71 ], cystic fibrosis [ 72 , 73 , 74 , 75 , 76 ], and COVID-19 [ 77 , 78 ].…”

Mass Spectrometry-Based Human Breath Analysis: Towards COVID-19 Diagnosis and Research

“…Although PCR technique is effective and sensitive for diagnosing COVID-19, many limitations such as sampling quality, sample pretreatment, and tedious result time were frequently reported in practice applications. False-negative results of PCR detection drive the new development of other supportive analytical methods for diagnosing COVID-19 [ 6 – 19 ]. To improve the accuracy of COVID-19 diagnosis, different clinical samples such as blood, urine, feces, saliva, and breath are considered for screening viruses or/and virus-specific metabolites [ 20 – 29 ], which are also expected to provide new insight into the health impact of COVID-19 [ 30 ].…”

A method for the identification of COVID-19 biomarkers in human breath using Proton Transfer Reaction Time-of-Flight Mass Spectrometry

“…Multiple studies presented the use of gas chromatography-ion mobility spectrometry (GC-IMS) for the breath analysis [ [14] , [15] , [16] , [17] ]. Ruszkiewicz and colleagues [16] presented a study in which ninety patients from Edinburgh, UK (65 patients, 10 positive COVID-19 cases) and Dortmund, Germany (25 patients, 17 positive COVID-19 cases) were tested.…”