Diagnosis of COVID-19 by Exhaled Breath Analysis Using Gas Chromatography Mass Spectrometry

Ibrahim, Wadah; Cordell, Rebecca; Wilde, Michael; Richardson, Mark W.; Carr, Liesl; Free, Robert C; Monks, Paul S.; Brightling, Christopher; Greening, NJ; Siddiqui, Salman

doi:10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3773

Cited by 6 publications

(8 citation statements)

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“…A sensitivity of 92.7%, a specificity of 95.5%, a positive predictive value (PPV) of 88.4%, a native predictive value (NPV) of 97.2%, and an overall accuracy of 94.7% are achieved (Table 2), which provide performance for training, testing, combined training and testing. The results are equivalent to or higher than previously reported breath analysis results involving patients in 2020 and 2021 [8][9][10][12][13][14][15]17,18,38 . The corresponding PCA plot is provided in Figure S5.…”

Section: Resultssupporting

confidence: 77%

“…Since the beginning of the pandemic, alternative methods of detection of COVID-19 infection have been and continue to be explored, including the use of exhaled breath using a number of technologies such as GC-IMS (gas chromatography in tandem with ion mobility spectrometry), Fourier-transform infrared spectroscopy, GC-MS (mass spectrometry), and others [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . The basis for these approaches is that exhaled breath contains hundreds of volatile organic compounds (VOCs), many of which are produced in response to inflammation and infection 19,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] .…”

Section: Introductionmentioning

confidence: 99%

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Portable Breath-Based Volatile Organic Compound Monitoring for the Detection of COVID-19: Challenges of Emerging Variants

Sharma

Zang

Tabartehfarahani

et al. 2022

Preprint

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Importance Breath analysis has been explored as a noninvasive means to detect COVID19. However, the impact of the emerging variants such as Omicron on the exhaled breath profile and hence the accuracy of breath analysis is unknown. Objective To evaluate the diagnostic accuracies of breath analysis on detecting COVID19 patients in periods where Delta and Omicron were most prevalent. Design, Setting, and Participants A convenience cohort of patients testing positive and negative for COVID19 using reverse transcriptase polymerase chain reaction (RTPCR) were studied and included 167 COVID and nonCOVID patients recruited between April 2021 and May 2022, which covers the period when Delta (and other variants prior to Delta) was the dominant variant (April to December 2021) and when Omicron was the dominant variant (January to May 2022). The breath from those patients were collected and analyzed for volatile organic compounds (VOCs) with a newly developed portable gas chromatography based breath analyzer. Diagnostic patterns and algorithms were developed. Results A total of 205 breath samples were analyzed from 167 COVID and nonCOVID patients. The RTPCR was conducted within 18 hours of the breath analysis to confirm the COVID status of the patients. Among 94 COVID positive samples, 41 samples were collected from the patients in 2021 who were assumed to be infected by the Delta variant (or other variants occurring in 2021) and 53 samples from the patients in 2022 who were assumed to be infected by the Omicron variant (BA.1 and BA.2). Breath analysis using a set of 4 VOC biomarkers was able to distinguish between COVID (Delta and other variants in 2021) and nonCOVID with an overall accuracy of 94.7%. However, the accuracy dropped significantly to 82.1% when the same set of biomarkers were applied to the Omicron variant with and 21 out of 53 COVID positive being misidentified. A new set of 4 VOC biomarkers were found to distinguish the Omicron variant and non-COVID, which yielded an overall accuracy of 90.9%. Breath analysis was also found to be able to distinguish between COVID (for all the variants occurring between April 2021 and May 2022) and nonCOVID with an overall accuracy of 90.2%, and between the Omicron variant and the earlier variants (Delta and other variants occurring in 2021) with an overall accuracy of 91.5%. Conclusions and Relevance Breath analysis of VOCs using point of care gas chromatography may be a promising diagnostic modality for detection of COVID and similar diseases that result in VOC production. However, similar to other diagnostic modalities such as rapid antigen testing, challenges are posed by the dynamic emergence of viral variants. The results of this study warrant additional investment and evaluation on how to overcome these challenges and to exploit breath analysis to improve the diagnosis and care of patients.

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Section: Resultssupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Portable Breath-Based Volatile Organic Compound Monitoring for the Detection of COVID-19: Challenges of Emerging Variants

Sharma

Zang

Tabartehfarahani

et al. 2022

Preprint

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“…Metabolic changes in breath have been studied for a variety of purposes, particularly the detection of biomarkers for cancer, 9,10 chronic obstructive pulmonary disease (COPD), 11 asthma, 12 malaria, 13,14 and COVID-19. [15][16][17][18] Exhaled breath is typically collected into an inert polymer bag (Tedlar), followed by collection onto tubes containing a sorbent material such as Tenax or a carbon-based material. 19 Alternatively, breath samples can also be collected using specialized breathing masks which enable the capture of breath volatiles directed onto sorbent tubes.…”

Section: Introductionmentioning

confidence: 99%

A headspace collection chamber for whole body volatilomics

Rankin‐Turner

McMeniman

2022

Preprint

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The human body secretes a complex blend of volatile organic compounds (VOCs) via the skin, breath and bodily fluids, the study of which can provide valuable insight into the physiological and metabolic state of an individual. Methods to profile human-derived volatiles typically source VOCs from bodily fluids, exhaled breath or skin of isolated body parts. To facilitate profiling the whole body volatilome, we have engineered a sampling chamber that enables the collection and analysis of headspace from the entire human body. Whole body VOCs were collected from a cohort of 20 humans and analyzed by thermal desorption-gas chromatography/mass spectrometry (TD-GC/MS) to characterize the compounds present in whole body headspace and evaluate chemical differences between individuals. A range of compounds were detected and identified in whole body headspace including ketones, carboxylic acids, aldehydes, alcohols, and aliphatic and aromatic hydrocarbons. Considerable heterogeneity in the chemical composition of whole body odor and the concentration of its constituent compounds was observed across individuals. Amongst the most common and abundant compounds detected in human whole body odor were sulcatone, acetoin, acetic acid and C6-C10 aldehydes. This method facilitates standardized and quantitative analytical profiling of the human whole body volatilome.

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“…Strikingly, in a completely unexpected result, our approach is able to distinguish between breath of men and women. Specifically, we find the DS-based AUC of 0.667 (12), sensitivity of 52 %, and specificity of 72 % (Fig. 4b), revealing a significant gender-based difference in exhaled breath.…”

Section: Resultsmentioning

confidence: 78%

“…We target the detection of Coronavirus Disease 2019 (COVID-19), a highly infectious disease with airborne transmission via aerosol and droplets 5 that has tragically caused many deaths globally 6 . In some exploratory COVID-19 breath testing efforts, studies have been conducted with small sample sizes of research subjects of different age groups (mainly above 40) and infection severity 7 using nanomaterial-based sensors 8,9 , ion-mobility spectrometry 10,11 , and mass-spectrometry 12,13 . We have performed breath analysis of COVID infected individuals in a unique manner.…”

Section: Introductionmentioning

confidence: 99%

Breath analysis by ultra-sensitive broadband laser spectroscopy detects SARS-CoV-2 infection

Liang¹,

Chan²,

Toscano³

et al. 2022

Preprint

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Human breath contains hundreds of volatile molecules that can provide powerful, non-intrusive spectral diagnosis of a diverse set of diseases and physiological/metabolic states. To unleash this tremendous potential for medical science, we present a robust analytical method that simultaneously measures tens of thousands of spectral features in each breath sample, followed by efficient and detail-specific multivariate data analysis for unambiguous binary medical response classification. We combine mid-infrared cavity-enhanced direct frequency comb spectroscopy (CE-DFCS), capable of real-time collection of tens of thousands of distinct molecular features at parts-per-trillion sensitivity, with supervised machine learning, capable of analysis and verification of extremely high-dimensional input data channels. Here, we present the first application

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Diagnosis of COVID-19 by Exhaled Breath Analysis Using Gas Chromatography Mass Spectrometry

Cited by 6 publications

References 0 publications

Portable Breath-Based Volatile Organic Compound Monitoring for the Detection of COVID-19: Challenges of Emerging Variants

Portable Breath-Based Volatile Organic Compound Monitoring for the Detection of COVID-19: Challenges of Emerging Variants

A headspace collection chamber for whole body volatilomics

Breath analysis by ultra-sensitive broadband laser spectroscopy detects SARS-CoV-2 infection

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