Detection of COVID-19 in hospitalised patients by exhaled breath analysis

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.