ABSTRACT
Introduction: SARS-COV-2 is mainly transmitted through respiratory droplets. The standard diagnostic procedure is based on a reverse transcription polymerase chain reaction (RT-PCR). Aim(s): 1) To develop a safe and easy to perform breath test for the detection of COVID-19 in hospitalised patients based on the analysis of volatile organic compounds (VOCs) in exhaled breath. 2) To differentiate in hospitalised patients with respiratory symptoms those with and without COVID-19. Method(s): We performed a monocenter, cross-sectional, case-control study in 38 subjects (63% males, age 62+/-12.7 yrs) admitted at the pulmonology ward. Breath samples were taken using a home-made sampling system. Analysis of breath samples was performed by proton transfer high resolution mass spectrometry (PTR-HRMS). A lassoregression with leave-one-out cross-validation was performed to differentiate the groups and designate the most differentiating VOCs. Result(s): COVID-19 positive (n=22) and control respiratory patients (n=16) were similar with respect to baseline characteristics, except for lower blood neutrophil and lymphocyte counts and higher ferritin level in COVID+ve patients (p<0.05). Lasso-regression revealed 6 VOCs as potential biomarkers that differentiated between both groups with 84% accuracy, 100% specificity and 100% positive predictive value based on PTR-HRMS data. Conclusion(s): Breath analysis could identify a breathprint differentiating between hospitalised COVID-19 and nonCOVID-19 patients with respiratory symptoms with a good accuracy. Therefore, VOCs profiling could be integrated in sensors allowing a fast breathalyzer for COVID-19 for large-scale screening.
ABSTRACT
Background: Early reports on cancer patients infected with COVID-19 have suggested a high mortality rate compared to the general population. Patients with thoracic malignancies are considered high risk given their age, preexisting comorbidities, smoking, and pre-existing lung damage in addition to therapies administered to treat their illness. Method: We launched a global consortium to collect data on patients with thoracic malignancies diagnosed with COVID-19 infection to understand the impact on this patient population. Goals of this consortium are to provide data for guidance to oncology professionals on treating patients with thoracic malignancies while understanding the risk factors for morbidity and mortality from this novel virus. Results: As of April 23, 2020, a total of 295 patients across 59 centers and 9 countries have been entered;median age 68, 31% female, 79% current/former smokers, HTN and COPD most common comorbidities;73% NSCLC, 14% SCLC, 4% meso and thymic, 49% patients with stage IV disease, majority on chemo or chemo-IO and 24% receiving RT. The use of IO or chemo-IO does not appear to impact risk of hospitalization, while treatment with TKI appears to be associated with a decreased risk of hospitalization. 73% patients required hospitalization, most common therapy given to treat COVID was antibiotics 67%, antivirals 33%, and steroids 30%. Conclusion: With an ongoing global pandemic of COVID-19 our data suggest that patients with thoracic malignancies are at high risk for hospitalization. Updated results to be presented will include impact on specific chemo-IO regimens and number of lines of therapy, which may impact hospitalization and risk of death as well as which therapies administered may impact survival in patients treated for COVID-19.