1
|
Long GA, Xu Q, Sunkara J, Woodbury R, Brown K, Huang JJ, Xie Z, Chen X, Fu XA, Huang J. A comprehensive meta-analysis and systematic review of breath analysis in detection of COVID-19 through Volatile organic compounds. Diagn Microbiol Infect Dis 2024; 109:116309. [PMID: 38692202 DOI: 10.1016/j.diagmicrobio.2024.116309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND The COVID-19 pandemic had profound global impacts on daily lives, economic stability, and healthcare systems. Diagnosis of COVID-19 infection via RT-PCR was crucial in reducing spread of disease and informing treatment management. While RT-PCR is a key diagnostic test, there is room for improvement in the development of diagnostic criteria. Identification of volatile organic compounds (VOCs) in exhaled breath provides a fast, reliable, and economically favorable alternative for disease detection. METHODS This meta-analysis analyzed the diagnostic performance of VOC-based breath analysis in detection of COVID-19 infection. A systematic review of twenty-nine papers using the grading criteria from Newcastle-Ottawa Scale (NOS) and PRISMA guidelines was conducted. RESULTS The cumulative results showed a sensitivity of 0.92 (95 % CI, 90 %-95 %) and a specificity of 0.90 (95 % CI 87 %-93 %). Subgroup analysis by variant demonstrated strong sensitivity to the original strain compared to the Omicron and Delta variant in detection of SARS-CoV-2 infection. An additional subgroup analysis of detection methods showed eNose technology had the highest sensitivity when compared to GC-MS, GC-IMS, and high sensitivity-MS. CONCLUSION Overall, these results support the use of breath analysis as a new detection method of COVID-19 infection.
Collapse
Affiliation(s)
- Grace A Long
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Qian Xu
- Biometrics and Data Science, Fosun Pharma, Beijing, PR China
| | - Jahnavi Sunkara
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Reagan Woodbury
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Katherine Brown
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | | | - Zhenzhen Xie
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA
| | - Xiaoyu Chen
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA.
| | - Xiao-An Fu
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA.
| | - Jiapeng Huang
- Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY, USA..
| |
Collapse
|
2
|
Xie Z, Morris JD, Pan J, Cooke EA, Sutaria SR, Balcom D, Marimuthu S, Parrish LW, Aliesky H, Huang JJ, Rai SN, Arnold FW, Huang J, Nantz MH, Fu XA. Detection of COVID-19 by quantitative analysis of carbonyl compounds in exhaled breath. Sci Rep 2024; 14:14568. [PMID: 38914586 PMCID: PMC11196736 DOI: 10.1038/s41598-024-61735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/09/2024] [Indexed: 06/26/2024] Open
Abstract
COVID-19 has caused a worldwide pandemic, creating an urgent need for early detection methods. Breath analysis has shown great potential as a non-invasive and rapid means for COVID-19 detection. The objective of this study is to detect patients infected with SARS-CoV-2 and even the possibility to screen between different SARS-CoV-2 variants by analysis of carbonyl compounds in breath. Carbonyl compounds in exhaled breath are metabolites related to inflammation and oxidative stress induced by diseases. This study included a cohort of COVID-19 positive and negative subjects confirmed by reverse transcription polymerase chain reaction between March and December 2021. Carbonyl compounds in exhaled breath were captured using a microfabricated silicon microreactor and analyzed by ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). A total of 321 subjects were enrolled in this study. Of these, 141 (85 males, 60.3%) (mean ± SD age: 52 ± 15 years) were COVID-19 (55 during the alpha wave and 86 during the delta wave) positive and 180 (90 males, 50%) (mean ± SD age: 45 ± 15 years) were negative. Panels of a total of 34 ketones and aldehydes in all breath samples were identified for detection of COVID-19 positive patients. Logistic regression models indicated high accuracy/sensitivity/specificity for alpha wave (98.4%/96.4%/100%), for delta wave (88.3%/93.0%/84.6%) and for all COVID-19 positive patients (94.7%/90.1%/98.3%). The results indicate that COVID-19 positive patients can be detected by analysis of carbonyl compounds in exhaled breath. The technology for analysis of carbonyl compounds in exhaled breath has great potential for rapid screening and detection of COVID-19 and for other infectious respiratory diseases in future pandemics.
Collapse
Affiliation(s)
- Zhenzhen Xie
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA
| | - James D Morris
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA
| | - Jianmin Pan
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- The Cancer Data Science Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Elizabeth A Cooke
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Saurin R Sutaria
- Department of Chemistry, University of Louisville, Louisville, KY, USA
| | - Dawn Balcom
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Subathra Marimuthu
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Leslie W Parrish
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Holly Aliesky
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | | | - Shesh N Rai
- Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- The Cancer Data Science Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Biostatistics and Informatics Shared Resource, University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Forest W Arnold
- Division of Infectious Diseases, Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Jiapeng Huang
- Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA.
| | - Michael H Nantz
- Department of Chemistry, University of Louisville, Louisville, KY, USA.
| | - Xiao-An Fu
- Department of Chemical Engineering, University of Louisville, Louisville, KY, USA.
| |
Collapse
|
3
|
Charles M, Ruszkiewicz D, Eckbo E, Bryce E, Zurberg T, Meister A, Aksu L, Navas L, Myers R. The science behind the nose: correlating volatile organic compound characterisation with canine biodetection of COVID-19. ERJ Open Res 2024; 10:00007-2024. [PMID: 38770004 PMCID: PMC11103684 DOI: 10.1183/23120541.00007-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/20/2024] [Indexed: 05/22/2024] Open
Abstract
Background The SARS-CoV-2 pandemic stimulated the advancement and research in the field of canine scent detection of COVID-19 and volatile organic compound (VOC) breath sampling. It remains unclear which VOCs are associated with positive canine alerts. This study aimed to confirm that the training aids used for COVID-19 canine scent detection were indeed releasing discriminant COVID-19 VOCs detectable and identifiable by gas chromatography (GC-MS). Methods Inexperienced dogs (two Labradors and one English Springer Spaniel) were trained over 19 weeks to discriminate between COVID-19 infected and uninfected individuals and then independently validated. Getxent tubes, impregnated with the odours from clinical gargle samples, used during the canines' maintenance training process were also analysed using GC-MS. Results Three dogs were successfully trained to detect COVID-19. A principal components analysis model was created and confirmed the ability to discriminate between VOCs from positive and negative COVID-19 Getxent tubes with a sensitivity of 78% and a specificity of 77%. Two VOCs were found to be very predictive of positive COVID-19 cases. When comparing the dogs with GC-MS, F1 and Matthew's correlation coefficient, correlation scores of 0.69 and 0.37 were observed, respectively, demonstrating good concordance between the two methods. Interpretation This study provides analytical confirmation that canine training aids can be safely and reliably produced with good discrimination between positive samples and negative controls. It is also a further step towards better understanding of canine odour discrimination of COVID-19 as the scent of interest and defining what VOC elements the canines interpret as "essential".
Collapse
Affiliation(s)
- Marthe Charles
- Division of Medical Microbiology, Vancouver Coastal Health, Vancouver, BC, Canada
- University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
| | - Dorota Ruszkiewicz
- University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
- British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Eric Eckbo
- Division of Medical Microbiology, Vancouver Coastal Health, Vancouver, BC, Canada
- University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
| | - Elizabeth Bryce
- Division of Medical Microbiology, Vancouver Coastal Health, Vancouver, BC, Canada
- Quality and Patient Safety, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Teresa Zurberg
- Quality and Patient Safety, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Austin Meister
- University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
| | - Lâle Aksu
- Quality and Patient Safety, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Leonardo Navas
- Quality and Patient Safety, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Renelle Myers
- University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada
- British Columbia Cancer Research Institute, Vancouver, BC, Canada
| |
Collapse
|
4
|
Bajo-Fernández M, Souza-Silva ÉA, Barbas C, Rey-Stolle MF, García A. GC-MS-based metabolomics of volatile organic compounds in exhaled breath: applications in health and disease. A review. Front Mol Biosci 2024; 10:1295955. [PMID: 38298553 PMCID: PMC10828970 DOI: 10.3389/fmolb.2023.1295955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/05/2023] [Indexed: 02/02/2024] Open
Abstract
Exhaled breath analysis, with particular emphasis on volatile organic compounds, represents a growing area of clinical research due to its obvious advantages over other diagnostic tests. Numerous pathologies have been extensively investigated for the identification of specific biomarkers in exhalates through metabolomics. However, the transference of breath tests to clinics remains limited, mainly due to deficiency in methodological standardization. Critical steps include the selection of breath sample types, collection devices, and enrichment techniques. GC-MS is the reference analytical technique for the analysis of volatile organic compounds in exhalates, especially during the biomarker discovery phase in metabolomics. This review comprehensively examines and compares metabolomic studies focusing on cancer, lung diseases, and infectious diseases. In addition to delving into the experimental designs reported, it also provides a critical discussion of the methodological aspects, ranging from the experimental design and sample collection to the identification of potential pathology-specific biomarkers.
Collapse
Affiliation(s)
- María Bajo-Fernández
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Érica A. Souza-Silva
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
- Departmento de Química, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Coral Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Ma Fernanda Rey-Stolle
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| | - Antonia García
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Boadilla del Monte, Spain
| |
Collapse
|