Breath testing for SARS-CoV-2 infectionResearch in context
Summary: Background: From a public health perspective, the identification of individuals with mild respiratory symptoms due to SARS-CoV-2 infection is important to contain the spread of the disease. The objective of this study was to identify volatile organic compounds (VOCs) in exhaled breath comm...
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Format: | Article |
Language: | English |
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Elsevier
2023-06-01
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Series: | EBioMedicine |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396423001494 |
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author | Renelle Myers Dorota M. Ruszkiewicz Austin Meister Crista Bartolomeu Sukhinder Atkar-Khattra C.L. Paul Thomas Stephen Lam |
author_facet | Renelle Myers Dorota M. Ruszkiewicz Austin Meister Crista Bartolomeu Sukhinder Atkar-Khattra C.L. Paul Thomas Stephen Lam |
author_sort | Renelle Myers |
collection | DOAJ |
description | Summary: Background: From a public health perspective, the identification of individuals with mild respiratory symptoms due to SARS-CoV-2 infection is important to contain the spread of the disease. The objective of this study was to identify volatile organic compounds (VOCs) in exhaled breath common to infection with different variants of the SARS-CoV-2 virus to inform the development of a point-of-care breath test to detect infected individuals with mild symptoms. Methods: A prospective, real-world, observational study was conducted on mildly symptomatic out-patients presenting to community test-sites for RT-qPCR SARS-CoV-2 testing when the Alpha, Beta, and Delta variants were driving the COVID-19 pandemic. VOCs in exhaled breath were compared between PCR-positive and negative individuals using TD-GC-ToF-MS. Candidate VOCs were tested in an independent set of samples collected during the Omicron phase of the pandemic. Findings: Fifty breath samples from symptomatic RT-qPCR positive and 58 breath samples from test-negative, but symptomatic participants were compared. Of the 50 RT-qPCR-positive participants, 22 had breath sampling repeated 8–12 weeks later. PCA-X model yielded 12 distinct VOCs that discriminated SARS-CoV-2 active infection compared to recovery/convalescence period, with an area under the receiver operator characteristic curve (AUROC), of 0.862 (0.747–0.977), sensitivity, and specificity of 82% and 86%, respectively. PCA-X model from 50 RT-qPCR positive and 58 negative symptomatic participants, yielded 11 VOCs, with AUROC of 0.72 (0.604–0.803) and sensitivity of 72%, specificity 65.5%. The 11 VOCs were validated in a separate group of SARS-CoV-2 Omicron positive patients’ vs healthy controls demonstrating an AUROC of 0.96 (95% CI 0.827–0.993) with sensitivity of 80% specificity of 90%. Interpretation: Exhaled breath analysis is a promising non-invasive, point-of-care method to detect mild COVID-19 infection. Funding: Funding for this study was a competitive grant awarded from the Vancouver Coastal Research Institute as well as funding from the BC Cancer Foundation. |
first_indexed | 2024-04-09T15:19:39Z |
format | Article |
id | doaj.art-bb1af5899b3d44e088d9eb9a11bba546 |
institution | Directory Open Access Journal |
issn | 2352-3964 |
language | English |
last_indexed | 2024-04-09T15:19:39Z |
publishDate | 2023-06-01 |
publisher | Elsevier |
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series | EBioMedicine |
spelling | doaj.art-bb1af5899b3d44e088d9eb9a11bba5462023-04-29T14:50:06ZengElsevierEBioMedicine2352-39642023-06-0192104584Breath testing for SARS-CoV-2 infectionResearch in contextRenelle Myers0Dorota M. Ruszkiewicz1Austin Meister2Crista Bartolomeu3Sukhinder Atkar-Khattra4C.L. Paul Thomas5Stephen Lam6Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Cancer Research Institute; Vancouver, British Columbia, Canada; Corresponding author. Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Cancer Research Institute; Vancouver, British Columbia, CanadaBritish Columbia Cancer Research Institute; Vancouver, British Columbia, CanadaBritish Columbia Cancer Research Institute; Vancouver, British Columbia, CanadaBritish Columbia Cancer Research Institute; Vancouver, British Columbia, CanadaCentre for Analytical Science, Department of Chemistry, Loughborough University, Loughborough, UKDepartment of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Cancer Research Institute; Vancouver, British Columbia, CanadaSummary: Background: From a public health perspective, the identification of individuals with mild respiratory symptoms due to SARS-CoV-2 infection is important to contain the spread of the disease. The objective of this study was to identify volatile organic compounds (VOCs) in exhaled breath common to infection with different variants of the SARS-CoV-2 virus to inform the development of a point-of-care breath test to detect infected individuals with mild symptoms. Methods: A prospective, real-world, observational study was conducted on mildly symptomatic out-patients presenting to community test-sites for RT-qPCR SARS-CoV-2 testing when the Alpha, Beta, and Delta variants were driving the COVID-19 pandemic. VOCs in exhaled breath were compared between PCR-positive and negative individuals using TD-GC-ToF-MS. Candidate VOCs were tested in an independent set of samples collected during the Omicron phase of the pandemic. Findings: Fifty breath samples from symptomatic RT-qPCR positive and 58 breath samples from test-negative, but symptomatic participants were compared. Of the 50 RT-qPCR-positive participants, 22 had breath sampling repeated 8–12 weeks later. PCA-X model yielded 12 distinct VOCs that discriminated SARS-CoV-2 active infection compared to recovery/convalescence period, with an area under the receiver operator characteristic curve (AUROC), of 0.862 (0.747–0.977), sensitivity, and specificity of 82% and 86%, respectively. PCA-X model from 50 RT-qPCR positive and 58 negative symptomatic participants, yielded 11 VOCs, with AUROC of 0.72 (0.604–0.803) and sensitivity of 72%, specificity 65.5%. The 11 VOCs were validated in a separate group of SARS-CoV-2 Omicron positive patients’ vs healthy controls demonstrating an AUROC of 0.96 (95% CI 0.827–0.993) with sensitivity of 80% specificity of 90%. Interpretation: Exhaled breath analysis is a promising non-invasive, point-of-care method to detect mild COVID-19 infection. Funding: Funding for this study was a competitive grant awarded from the Vancouver Coastal Research Institute as well as funding from the BC Cancer Foundation.http://www.sciencedirect.com/science/article/pii/S2352396423001494SARS-CoV-2Breath-testingBiomarkersVOCsGC-MS |
spellingShingle | Renelle Myers Dorota M. Ruszkiewicz Austin Meister Crista Bartolomeu Sukhinder Atkar-Khattra C.L. Paul Thomas Stephen Lam Breath testing for SARS-CoV-2 infectionResearch in context EBioMedicine SARS-CoV-2 Breath-testing Biomarkers VOCs GC-MS |
title | Breath testing for SARS-CoV-2 infectionResearch in context |
title_full | Breath testing for SARS-CoV-2 infectionResearch in context |
title_fullStr | Breath testing for SARS-CoV-2 infectionResearch in context |
title_full_unstemmed | Breath testing for SARS-CoV-2 infectionResearch in context |
title_short | Breath testing for SARS-CoV-2 infectionResearch in context |
title_sort | breath testing for sars cov 2 infectionresearch in context |
topic | SARS-CoV-2 Breath-testing Biomarkers VOCs GC-MS |
url | http://www.sciencedirect.com/science/article/pii/S2352396423001494 |
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