Breath-borne VOC Biomarkers for COVID-19

Abstract

Rapid diagnosis of COVID-19 is key to controlling the pandemic. Here we report the potential breath-borne volatile organic compound (VOC) biomarkers for COVID-19. Higher levels of ethyl butanoate were detected in exhaled breath of COVID-19 patients (N=10) than healthy controls/health care workers (N=21), lung cancer (LC) patients (N=7) and backgrounds. In contrast, breath-borne butyraldehyde and isopropanol (an efficient SARS-CoV-2 inactivation agent) were significantly higher for non-COVID-19 respiratory infections (URTI) (N=22) than COVID-19, HC, LC patients and backgrounds. Breath-borne isopropanol emission from COVID-19 patients varied greatly up to ~100-fold difference. COVID-19 patients had lower acetone levels than other subjects, except LC patients. The monitoring of ethyl butanoate, butyraldehyde and isopropanol could lend considerable support in rapidly screening COVID-19; and alerting the presence of COVID-19 patient in particular environments.

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“…acetone), alcohols (e.g. isopropanol, methanol) and an alkadiene (2,4-octadiene) to differentiate between those with and without COVID-19 (4, 31, 32). Furthermore, in a small study using a multi-capillary column coupled ion mobility spectrometry (MCC-IMS), Steppert et al .…”

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“…Meanwhile, the other clinical GC-IMS study conducted by researchers in Beijing, China, suggested several other potential breath-borne VOC biomarkers for COVID-19 (i.e., acetone (C 3 H 6 O), ethyl butanoate, butyraldehyde, and isopropanol). 62 They found that the decrease and rise of acetone (C 3 H 6 O) and ethyl butanoate levels, respectively, due to the changes of metabolites resulting from SARS-CoV-2 infections, were distinctive for COVID-19 patients. 62,63 Moreover, the average measured isopropanol and butyraldehyde for the COVID-19 patients were lower than those for the healthy control, lung cancer, and non-COVID-19 respiratory infection patients.…”

“…89 However, in patients with positive COVID-19, acetone was reported to be in a lower proportion, compared to health care worker or healthy control group. 62 Meanwhile, other VOC (i.e., ethyl butanoate) has also been reported as one of signature VOCs in COVID-19 patients where its concentration is slightly higher compared to healthy control. 62 Our breath analysis study will be extended in combination with GC-MS to identify the speci c VOC biomarkers that are distinctive for COVID-19 cases in Indonesia.…”

“…This gas sensing con guration utilizing microsyringe for vapor injection has already been used in our former experiments for other VOC sensor types (e.g., nano berfunctionalized QCMs). 36,70,71 Acetone was chosen as a VOC model because it is not only produced in the rebreathed breath (0.8 to 2.0 ppm) 72 but also indicated as one of the signi cant breath-borne COVID-19 biomarkers based on the study by Chen et al 62 Moreover, in the clinical practices, breath-containing acetone has also been extensively examined to diagnose some other diseases (i.e., lung cancer, diabetes mellitus, starvation, and ketogenic diet). 73 From the obtained measurement results shown in Figures S2b and c, the S3 and S7 sensors (or their extracted features of F3 and F7) demonstrated the poorest responses toward acetone vapors.…”

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“…Two recent reports showed that the potential volatile organic compounds (VOC) marker contain higher ethyl butyrate levels than healthy control ( 76 , 77 ). The markers used by breath analyzers are reported to be related to COVID-19 disruption of respiratory biochemistry resulting from ketosis, inflammatory processes, and gastrointestinal effects ( 78 ).…”