Diagnosis of COVID-19 by exhaled breath analysis using gas chromatography-mass spectrometry

  1. Wadah Ibrahim1,2,4,
  2. Rebecca L. Cordell3,4,
  3. Michael J. Wilde3,
  4. Matthew Richardson1,2,
  5. Liesl Carr1,2,
  6. Ananga Sundari Devi Dasi1,2,
  7. Beverley Hargadon1,2,
  8. Robert C. Free1,2,
  9. Paul S. Monks3,
  10. Christopher E. Brightling1,2,
  11. Neil J. Greening1,2 and
  12. Salman Siddiqui1,2⇑
  13. on behalf of the EMBER consortium
  1. 1Department of Respiratory Sciences, University of Leicester, Leicester, UK
  2. 2Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
  3. 3School of Chemistry, University of Leicester, Leicester, UK
  4. 4Equal contribution to work
  1. Professor Salman Siddiqui, Clinical Professor of Airways Disease, Chief Investigator EMBER molecular pathology node & NIHR BEAT-Severe Asthma, National Respiratory Stratified Medicines Champion, College of Life Sciences, University of Leicester, NIHR Biomedical Research Centre (Respiratory theme), Institute for Lung Health, Leicester, UK. E-mail: ss338{at}le.ac.uk

Abstract

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.

Footnotes

This 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.

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  • Received March 2, 2021.
  • Accepted April 24, 2021.
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