IABR Symposium 2021 meeting report: breath standardization, sampling, and testing in a time of COVID-19

Schmidt, Alexander J; Salman, Dahlia; Pleil, Joachim D.; Thomas, C. L. Paul; Davis, Cristina E.

doi:10.1088/1752-7163/ac3096

Cited by 8 publications

(9 citation statements)

References 16 publications

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“…Carvone, a trace level component of peppermint oil capsule was suppressed by both filters and was only detected in 3 out of 18 filtered samples, where in non-filtered samples the compound was found in 6 out of 9 cases. Similar effect of use of filters on detection of peppermint oil components in breath was observed and described in another study [18]. Similarly, ethanol, benzaldehyde and 3methyl thiophene (commonly reported breath biomarkers) were also suppressed when using the Spiro filter and benzene_1_2_4_5_tetramethyl when using syringe filter.…”

Section: Filter Resultssupporting

confidence: 82%

Breath collection protocol for SARS-CoV-2 testing in an ambulatory setting

Myers

Ruszkiewicz²,

Meister

et al. 2022

J. Breath Res.

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Breath research during the SARS-CoV-2 pandemic offers an opportunity for discovery of a rapid point-of-care screening test, but also introduces a hazard to researchers collecting, transporting and analyzing breath samples not only for COVID -19 research, but all human breath-related research during the ongoing pandemic. Safe workflows to protect study participants and staff collecting and analysing the samples must be determined. We developed a SARS-CoV-2 breath test protocol for collection and processing of breath samples in ambulatory care COVID-19 testing sites and prospectively evaluated the protocol. 528 breath samples from 393 participants at COVID-19 testing sites were safely collected, transported, stored, and analysed with zero transmission to staff. Our method development for the safe collection of samples included the examination of 2 different filters for added safety. We discovered the use of filters leads to increased sample contamination and/or reduction of endogenous features in breath samples. Personal protective equipment (PPE) is essential for all breath collection while SARS-CoV-2 remains wide-spread through the general population. We have demonstrated that use of completely disposable breath collection devices and PPE, are sufficient for safe collection. Filters in the workflow add complexity to an already complex breath matrix and may compromise bio-safety.

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Section: Filter Resultssupporting

confidence: 82%

Breath collection protocol for SARS-CoV-2 testing in an ambulatory setting

Myers

Ruszkiewicz²,

Meister

et al. 2022

J. Breath Res.

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“…Clinical practices have been developed to safely collect, handle, and deactivate potentially transmissible viral material in breath vapor samples for COVID-19 screening [11][12][13] . Worldwide, breath research groups have shown that exhaled vapor reflects SARS-CoV-2 infection status [14][15][16] .…”

mentioning

confidence: 99%

Predominant SARS-CoV-2 variant impacts accuracy when screening for infection using exhaled breath vapor

et al. 2022

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Background New technologies with novel and ambitious approaches are being developed to diagnose or screen for SARS-CoV-2, including breath tests. The US FDA approved the first breath test for COVID-19 under emergency use authorization in April 2022. Most breath-based assays measure volatile metabolites exhaled by persons to identify a host response to infection. We hypothesized that the breathprint of COVID-19 fluctuated after Omicron became the primary variant of transmission over the Delta variant. Methods We collected breath samples from 142 persons with and without a confirmed COVID-19 infection during the Delta and Omicron waves. Breath samples were analyzed by gas chromatography-mass spectrometry. Results Here we show that based on 63 exhaled compounds, a general COVID-19 model had an accuracy of 0.73 ± 0.06, which improved to 0.82 ± 0.12 when modeling only the Delta wave, and 0.84 ± 0.06 for the Omicron wave. The specificity improved for the Delta and Omicron models (0.79 ± 0.21 and 0.74 ± 0.12, respectively) relative to the general model (0.61 ± 0.13). Conclusions We report that the volatile signature of COVID-19 in breath differs between the Delta-predominant and Omicron-predominant variant waves, and accuracies improve when samples from these waves are modeled separately rather than as one universal approach. Our findings have important implications for groups developing breath-based assays for COVID-19 and other respiratory pathogens, as the host response to infection may significantly differ depending on variants or subtypes.

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“…We have witnessed the ubiquitous hurdles faced by the scientists and/or clinicians while dealing with SARS-CoV-2 infected subjects 17 , 18 . Mandatory safety and precaution measures have often overruled/compromised sampling and analytical requirements/standards, which have affected the quality, reliability and reproducibility of obtained data 19 , 20 .…”

Section: Introductionmentioning

confidence: 99%

Advanced setup for safe breath sampling and patient monitoring under highly infectious conditions in the clinical environment

Sukul

Trefz²,

Schubert³

et al. 2022

Sci Rep

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Being the proximal matrix, breath offers immediate metabolic outlook of respiratory infections. However, high viral load in exhalations imposes higher transmission risk that needs improved methods for safe and repeatable analysis. Here, we have advanced the state-of-the-art methods for real-time and offline mass-spectrometry based analysis of exhaled volatile organic compounds (VOCs) under SARS-CoV-2 and/or similar respiratory conditions. To reduce infection risk, the general experimental setups for direct and offline breath sampling are modified. Certain mainstream and side-stream viral filters are examined for direct and lab-based applications. Confounders/contributions from filters and optimum operational conditions are assessed. We observed immediate effects of infection safety mandates on breath biomarker profiles. Main-stream filters induced physiological and analytical effects. Side-stream filters caused only systematic analytical effects. Observed substance specific effects partly depended on compound’s origin and properties, sampling flow and respiratory rate. For offline samples, storage time, -conditions and -temperature were crucial. Our methods provided repeatable conditions for point-of-care and lab-based breath analysis with low risk of disease transmission. Besides breath VOCs profiling in spontaneously breathing subjects at the screening scenario of COVID-19/similar test centres, our methods and protocols are applicable for moderately/severely ill (even mechanically-ventilated) and highly contagious patients at the intensive care.

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IABR Symposium 2021 meeting report: breath standardization, sampling, and testing in a time of COVID-19

Cited by 8 publications

References 16 publications

Breath collection protocol for SARS-CoV-2 testing in an ambulatory setting

Breath collection protocol for SARS-CoV-2 testing in an ambulatory setting

Predominant SARS-CoV-2 variant impacts accuracy when screening for infection using exhaled breath vapor

Advanced setup for safe breath sampling and patient monitoring under highly infectious conditions in the clinical environment

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