RT Journal Article SR Electronic T1 Diagnosis of COVID-19 by exhaled breath analysis using gas chromatography-mass spectrometry JF ERJ Open Research JO erjor FD European Respiratory Society SP 00139-2021 DO 10.1183/23120541.00139-2021 A1 Wadah Ibrahim A1 Rebecca L. Cordell A1 Michael J. Wilde A1 Matthew Richardson A1 Liesl Carr A1 Ananga Sundari Devi Dasi A1 Beverley Hargadon A1 Robert C. Free A1 Paul S. Monks A1 Christopher E. Brightling A1 Neil J. Greening A1 Salman Siddiqui A1 , YR 2021 UL http://openres.ersjournals.com/content/early/2021/04/29/23120541.00139-2021.abstract AB Background The ongoing COVID-19 pandemic has claimed over two and a half million lives worldwide so far. SARS-CoV-2 infection is perceived to be seasonally recurrent and a rapid non-invasive biomarker to accurately diagnose patients early-on in their disease course will be necessary to meet the operational demands for COVID-19 control in the coming years.Objective To evaluate the role of exhaled breath volatile biomarkers in identifying patients with suspected or confirmed COVID-19 infection, based on their underlying PCR status and clinical probability.Methods A prospective, real-world, observational study recruiting adult patients with suspected or confirmed COVID-19 infection. Breath samples were collected using a standard breath collection bag, modified with appropriate filters to comply with local infection control recommendations and samples were analysed using gas chromatography-mass spectrometry (TD-GC-MS).Findings 81 patients were recruited between April 29th to July 10th, 2020, of whom 52/81 (64%) tested positive for COVID-19 by RT-PCR. A regression analysis identified a set of seven exhaled breath features (benzaldehyde, 1-propanol, 3, 6-methylundecane, camphene, beta-cubebene, Iodobenzene, and an unidentified compound) that separated PCR positive patients with an area under the curve (AUC): 0.836, sensitivity: 68%, specificity: 85%.Conclusions GC-MS detected exhaled breath biomarkers were able to identify PCR positive COVID-19 patients. External replication of these compounds is warranted to validate these results.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Ibrahim has nothing to disclose.Conflict of interest: Dr. Cordell has nothing to disclose.Conflict of interest: Dr. Wilde has nothing to disclose.Conflict of interest: Dr. Richardson has nothing to disclose.Conflict of interest: Mrs. Carr has nothing to disclose.Conflict of interest: Miss. Sundari Devi dasi has nothing to disclose.Conflict of interest: Ms. Hargadon has nothing to disclose.Conflict of interest: Dr. Free has nothing to disclose.Conflict of interest: Professor Monks has nothing to disclose.Conflict of interest: Professor Brightling has nothing to disclose.Conflict of interest: Dr. Greening has nothing to disclose.Conflict of interest: Professor Siddiqui has nothing to disclose.