A breath of fresh air – the potential for COVID-19 breath diagnostics

Davis, Cristina E.; Schivo, Michael; Kenyon, Nicholas J.

doi:10.1016/j.ebiom.2020.103183

Cited by 21 publications

(21 citation statements)

References 10 publications

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“…A comprehensive human breathomics reference database containing data on 913 VOCs from 2766 published literature was developed, which are linked to several respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (Kuo et al, 2020). Exhaled air is considered as a very convenient specimen for respiratory diseases including viral infections because of the non-invasive nature and the ease of collection of the specimen (Davis et al, 2021).…”

Section: Analysis Of Volatile Organic Compounds (Vocs) In the Exhaled Airmentioning

confidence: 99%

Metabolomics in the Diagnosis and Prognosis of COVID-19

2021

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Coronavirus disease 2019 (COVID-19) pandemic triggered an unprecedented global effort in developing rapid and inexpensive diagnostic and prognostic tools. Since the genome of SARS-CoV-2 was uncovered, detection of viral RNA by RT-qPCR has played the most significant role in preventing the spread of the virus through early detection and tracing of suspected COVID-19 cases and through screening of at-risk population. However, a large number of alternative test methods based on SARS-CoV-2 RNA or proteins or host factors associated with SARS-CoV-2 infection have been developed and evaluated. The application of metabolomics in infectious disease diagnostics is an evolving area of science that was boosted by the urgency of COVID-19 pandemic. Metabolomics approaches that rely on the analysis of volatile organic compounds exhaled by COVID-19 patients hold promise for applications in a large-scale screening of population in point-of-care (POC) setting. On the other hand, successful application of mass-spectrometry to detect specific spectral signatures associated with COVID-19 in nasopharyngeal swab specimens may significantly save the cost and turnaround time of COVID-19 testing in the diagnostic microbiology and virology laboratories. Active research is also ongoing on the discovery of potential metabolomics-based prognostic markers for the disease that can be applied to serum or plasma specimens. Several metabolic pathways related to amino acid, lipid and energy metabolism were found to be affected by severe disease with COVID-19. In particular, tryptophan metabolism via the kynurenine pathway were persistently dysregulated in several independent studies, suggesting the roles of several metabolites of this pathway such as tryptophan, kynurenine and 3-hydroxykynurenine as potential prognostic markers of the disease. However, standardization of the test methods and large-scale clinical validation are necessary before these tests can be applied in a clinical setting. With rapidly expanding data on the metabolic profiles of COVID-19 patients with varying degrees of severity, it is likely that metabolomics will play an important role in near future in predicting the outcome of the disease with a greater degree of certainty.

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Section: Analysis Of Volatile Organic Compounds (Vocs) In the Exhaled Airmentioning

confidence: 99%

Metabolomics in the Diagnosis and Prognosis of COVID-19

2021

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“…Notably, breath analysis has received unprecedented attention recently in relation to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak and the associated coronavirus disease 2019 (COVID-19) pandemic. The potential for exhaled breath to either detect this airborne virus directly or to diagnose infection is currently being investigated as a comfortable alternative to existing approaches that collect mucus secretions via nasopharyngeal or oropharyngeal swabs, or serological samples [ 249 , 250 , 251 ]. While no breath test has yet been developed that allows a reliable detection of the infection, studies have reported potential breath-borne VOC biomarkers (detected via gas chromatography ion mobility spectrometry, GC-IMS) [ 252 ] or specific breathprints (using proton transfer reaction time-of-flight mass spectrometry, PTR-TOF-MS) [ 253 ] for COVID-19, as well as evidence for tests using nanomaterial-based sensors [ 254 ].…”

Section: Discussionmentioning

confidence: 99%

Breath Biomarkers in Diagnostic Applications

Pham

Beauchamp

2021

Molecules

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The detection of chemical compounds in exhaled human breath presents an opportunity to determine physiological state, diagnose disease or assess environmental exposure. Recent advancements in metabolomics research have led to improved capabilities to explore human metabolic profiles in breath. Despite some notable challenges in sampling and analysis, exhaled breath represents a desirable medium for metabolomics applications, foremost due to its non-invasive, convenient and practically limitless availability. Several breath-based tests that target either endogenous or exogenous gas-phase compounds are currently established and are in practical and/or clinical use. This review outlines the concept of breath analysis in the context of these unique tests and their applications. The respective breath biomarkers targeted in each test are discussed in relation to their physiological production in the human body and the development and implementation of the associated tests. The paper concludes with a brief insight into prospective tests and an outlook of the future direction of breath research.

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“…64 Overall, those previously reported mass spectrometry studies in several different countries (i.e., UK, Germany, France, and China) indicate that the distinctive VOC biomarkers for COVID-19 may vary across the world and should be further investigated based on community, races, and case-by-case with larger cohorts. 65 In contrast to a mass spectrometry method that attempts to nd and identify the exact VOC biomarkers from the exhaled breaths quantitatively, our technique used in the GeNose C19 has focused more on the AI-based pattern analysis of the integrated sensor responses to those complex VOCs qualitatively resulting from the combined extra-pulmonary metabolic and gastrointestinal manifestations of COVID-19. 66 Thus, the breath data analysis and decision making procedure can be carried out in a simpler way and a shorter time, respectively, with high detection accuracy.…”

Section: Sensor Characteristics To Exhaled Breathsmentioning

confidence: 99%

Fast and noninvasive electronic nose for sniffing out COVID-19 based on exhaled breath-print recognition

Nurputra

Kusumaatmadja

Hakim

et al. 2021

Preprint

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Despite its high accuracy to detect the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the reverse transcription-quantitative polymerase chain reaction (RT-qPCR) approach possesses several limitations (e.g., the lengthy invasive procedure, the reagent availability, and the requirement of specialized laboratory, equipment, and trained staffs). We developed and employed a low-cost, noninvasive method to rapidly sniff out the coronavirus disease 2019 (COVID-19) based on a portable electronic nose (GeNose C19) integrating metal oxide semiconductor gas sensor array, optimized feature extraction, and machine learning models. This approach was evaluated in profiling tests involving a total number of 615 breath samples (i.e., 333 positive and 282 negative COVID-19 confirmed by RT-qPCR) obtained from 83 patients in two hospitals located in the Special Region of Yogyakarta, Indonesia. Four different machine learning algorithms (i.e., linear discriminant analysis (LDA), support vector machine (SVM), stacked multilayer perceptron (MLP), and deep neural network (DNN)) were utilized to identify the top-performing pattern recognition methods and to obtain high system detection accuracy (88–95%), sensitivity (86–94%), specificity (88–95%) levels from the testing datasets. Our results suggest that GeNose C19 can be considered a highly potential breathalyzer for fast COVID-19 screening.

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A breath of fresh air – the potential for COVID-19 breath diagnostics

Cited by 21 publications

References 10 publications

Metabolomics in the Diagnosis and Prognosis of COVID-19

Metabolomics in the Diagnosis and Prognosis of COVID-19

Breath Biomarkers in Diagnostic Applications

Fast and noninvasive electronic nose for sniffing out COVID-19 based on exhaled breath-print recognition

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