Exhaled breath condensate biomarkers in critically ill, mechanically ventilated patients

Davis, Michael D.; Winters, Brett R.; Madden, Michael C.; Pleil, Joachim D.; Sessler, Curtis N.; Wallace, M. Ariel Geer; Ward‐Caviness, Cavin; Montpetit, Alison

doi:10.1088/1752-7163/abc235

Cited by 6 publications

(4 citation statements)

References 33 publications

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“…EBC collection was conducted using an R-tube® or R-tubeVent® device (Respiratory Research). The Rtubes were placed inside an aluminum sleeve surrounded by dry ice within an 8 cm diameter co-axial container [10,11]. Alternatively, five sleeves were stored in a cooler box with dry ice and exchanged every minute.…”

Section: Ebc Collection and Safety Measuresmentioning

confidence: 99%

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RT-PCR diagnosis of COVID-19 from exhaled breath condensate: a clinical study

et al. 2021

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Current diagnostic testing for coronavirus disease 2019 (COVID-19) is based on detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swab samples by reverse transcription polymerase chain reaction (RT-PCR). However, this test is associated with increased risks of viral dissemination and environmental contamination and shows relatively low sensitivity, attributable to technical deficiencies in the sampling method. Given that COVID-19 is transmitted via exhaled aerosols and droplets, and that exhaled breath condensate (EBC) is an established modality for sampling exhaled aerosols, detection of SARS-CoV-2 in EBC offers a promising diagnostic approach. However, current knowledge on the detection and load of the virus in EBC collected from COVID-19 patients remains limited and inconsistent. The objective of the study was to quantify the viral load in EBC collected from COVID-19 patients and to validate the feasibility of SARS-CoV-2 detection from EBC as a diagnostic test for the infection. EBC samples were collected from 48 COVID-19 patients using a collection device, and viral loads were quantified by RT-PCR targeting the E gene. Changes in detection rates and viral loads relative to patient characteristics and days since disease onset were statistically evaluated. Need for mechanical ventilation was significantly associated with higher viral load (p < 0.05). Need for oxygen administration or mechanical ventilation, less than 3 d since onset, and presence of cough or fever were significantly associated with higher detection rates (p < 0.05). Among spontaneously breathing patients, viral load in EBC attenuated exponentially over time. The detection rate was 86% at 2 d since onset and deteriorated thereafter. In mechanically ventilated patients, detection rate and viral load were high regardless of days since onset. These results support the feasibility of using RT-PCR to detect SARS-CoV-2 from EBC for COVID-19 patients within 2 d of symptom onset.

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Section: Ebc Collection and Safety Measuresmentioning

confidence: 99%

“…The bag (triple-sealed EBC sample) was dropped into a cooler box containing dry ice in the 'green zone' and immediately transported to a PCR laboratory certified as Biosafety Level 2+. Alternatively, the bag was stored at ultra-low temperature (−89 • C) in a deep freezer [11].…”

Section: Transportation Of Ebc Samples To Pcr Laboratorymentioning

confidence: 99%

RT-PCR diagnosis of COVID-19 from exhaled breath condensate: a clinical study

et al. 2021

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“…Severe dyspnea may cause exacerbation, additional pneumothorax, and hemodynamic instability. Shock, significant bleeding, and coagulopathy may prevent bronchoscopy [8] . BALF-GM is difficult to get from unstable mechanically ventilated individuals.…”

Section: Introductionmentioning

confidence: 99%

RETRACTED: Non-Invasive Detection of Aspergillosis in Ventilated Patients: Galactomannan Analysis in Exhaled Breath

Tang,

Yang,

Zhang

et al. 2024

Preprint

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“…The Rtubes were placed inside an aluminum cooling sleeve. Five sleeves were stored in a cooler box with dry ice and exchanged every minute to ensure collection at ultra-low temperature [12,13]. The whole device was disposed of as infectious medical waste after EBC collection, except for the sleeve, which was disinfected by submersion in 75 vol% ethanol before reuse.…”

Section: Ebc Collection and Safety Measuresmentioning

confidence: 99%

SARS-CoV-2 RNA load and detection rate in exhaled breath condensate collected from COVID-19 patients infected with Delta variant

et al. 2022

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant is considered responsible for worldwide surges in coronavirus disease 2019 (COVID-19) cases in 2021, with increased infectivity compared to the wild type (Wuhan-1). In a previous study, we identified temporal changes in wild-type SARS-CoV-2 RNA load and detection rate in EBC collected from COVID-19 patients. The primary objective of this study was to clarify temporal changes in Delta-variant SARS-CoV-2 RNA load and detection rates in EBC collected from patients, and to validate the feasibility of Delta-variant SARS-CoV-2 RNA detection from EBC for diagnosing COVID-19. The secondary objective was to compare SARS-CoV-2 RNA loads in EBC between Delta-variant and wild-type. Subjects were 41 COVID-19 patients infected with the Delta-variant. EBC samples were collected from subjects on the day of or the day after admission using R-tube® (Respiratory Research, Austin, Texas, USA), as in our previous study. SARS-CoV-2 RNA in EBC samples was detected and quantified by RT-PCR assay targeting the E gene, using the same settings and reagents as in the previous study. The results indicated that SARS-CoV-2 RNA load in EBC collected from subjects infected with Delta-variant decreased exponentially with the passage of days from symptom onset. Sustained high detection rates support the feasibility of Delta-variant SARS-CoV-2 RNA detection from EBC by RT-PCR assay as a diagnostic test for COVID-19 within 8 days of onset. SARS-CoV-2 RNA load in EBC collected 2–8 days from onset was significantly higher in Delta-variant-infected subjects than in wild-type-infected subjects on a day-to-day basis (p=0.005–0.029). However, because of the heterogeneity of the study cohort, conclusions cannot be reached regarding differences in viral RNA load between strains, regardless of the timing of EBC collection.

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Exhaled breath condensate biomarkers in critically ill, mechanically ventilated patients

Cited by 6 publications

References 33 publications

RT-PCR diagnosis of COVID-19 from exhaled breath condensate: a clinical study

RT-PCR diagnosis of COVID-19 from exhaled breath condensate: a clinical study

RETRACTED: Non-Invasive Detection of Aspergillosis in Ventilated Patients: Galactomannan Analysis in Exhaled Breath

SARS-CoV-2 RNA load and detection rate in exhaled breath condensate collected from COVID-19 patients infected with Delta variant

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