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Voit F, Erber J, Feuerherd M, Fries H, Bitterlich N, Diehl-Wiesenecker E, Gladis S, Lieb J, Protzer U, Schneider J, Geisler F, Somasundaram R, Schmid RM, Bauer W, Spinner CD. Rapid point-of-care detection of SARS-CoV-2 infection in exhaled breath using ion mobility spectrometry: a pilot study. Eur J Med Res 2023; 28:318. [PMID: 37660038 PMCID: PMC10474630 DOI: 10.1186/s40001-023-01284-3] [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: 02/24/2023] [Accepted: 08/12/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND An effective testing strategy is essential for pandemic control of the novel Coronavirus disease 2019 (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Breath gas analysis can expand the available toolbox for diagnostic tests by using a rapid, cost-beneficial, high-throughput point-of-care test. We conducted a bi-center clinical pilot study in Germany to evaluate breath gas analysis using multi-capillary column ion mobility spectrometry (MCC-IMS) to detect SARS-CoV-2 infection. METHODS Between September 23, 2020, and June 11, 2021, breath gas measurements were performed on 380 patients (SARS-CoV-2 real-time polymerase chain reaction (PCR) positive: 186; PCR negative: 194) presenting to the emergency department (ED) with respiratory symptoms. RESULTS Breath gas analysis using MCC-IMS identified 110 peaks; 54 showed statistically significant differences in peak intensity between the SARS-CoV-2 PCR-negative and PCR-positive groups. A decision tree analysis classification resulted in a sensitivity of 83% and specificity of 86%, but limited robustness to dataset changes. Modest values for the sensitivity (74%) and specificity (52%) were obtained using linear discriminant analysis. A systematic search for peaks led to a sensitivity of 77% and specificity of 67%; however, validation by transferability to other data is questionable. CONCLUSIONS Despite identifying several peaks by MCC-IMS with significant differences in peak intensity between PCR-negative and PCR-positive samples, finding a classification system that allows reliable differentiation between the two groups proved to be difficult. However, with some modifications to the setup, breath gas analysis using MCC-IMS may be a useful diagnostic toolbox for SARS-CoV-2 infection. TRIAL REGISTRATION This study was registered at ClinicalTrials.gov on September 21, 2020 (NCT04556318; Study-ID: HC-N-H-2004).
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Affiliation(s)
- Florian Voit
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - J Erber
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - M Feuerherd
- Institute of Virology, Helmholtz Center Munich, TUM, School of Medicine, Munich, Germany
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - H Fries
- B. Braun Melsungen AG, Melsungen, Germany
| | - N Bitterlich
- ABX-CRO Advanced Pharmaceutical Services Forschungsgesellschaft mbH, Dresden, Germany
| | - E Diehl-Wiesenecker
- Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - S Gladis
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - J Lieb
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - U Protzer
- Institute of Virology, Helmholtz Center Munich, TUM, School of Medicine, Munich, Germany
- German Center for Infection Research (DZIF), Munich Partner Site, Munich, Germany
| | - J Schneider
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - F Geisler
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - R Somasundaram
- Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - R M Schmid
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - W Bauer
- Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - C D Spinner
- Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
- German Center for Infection Research (DZIF), Munich Partner Site, Munich, Germany
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A comparison between mobile and stationary gas chromatography-mass spectrometry devices for analysis of complex volatile profiles. Anal Bioanal Chem 2023; 415:137-155. [PMID: 36396731 PMCID: PMC9672629 DOI: 10.1007/s00216-022-04391-y] [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: 08/30/2021] [Revised: 08/25/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022]
Abstract
On-site analysis of volatile organic compounds (VOCs) with miniaturized gas chromatography-mass spectrometry (GC-MS) systems is a very rapidly developing field of application. While, on the one hand, major technological advances are improving the availability of these systems on the market, on the other hand, systematic studies to assess the performance of such instruments are still lacking. To fill this gap, we compared three portable GC-MS devices to a state-of-the-art benchtop (stationary) system for analysis of a standard mixture of 18 VOCs. We systematically compared analytical parameters such as the sensitivity and similarity of the signal response pattern and the quality of the obtained mass spectra. We found that the investigated mobile instruments (i) showed different response profiles with a generally lower number of identified analytes. Also, (ii) mass spectral reproducibility (% relative standard deviation (RSD) of the relative abundance of selective fragments) was generally worse in the mobile devices (mean RSD for all targeted fragments ~9.7% vs. ~3.5% in the stationary system). Furthermore, mobile devices (iii) showed a poorer mass spectral similarity to commercial reference library spectra (>20% deviation of fragment ion relative intensity vs. ~10% in the stationary GC-MS), suggesting a less reliable identification of analytes by library search. Indeed, (iv) the performance was better with higher-mass and/or more abundant fragments, which should be considered to improve the results of library searches for substance identification. Finally, (v) the estimation of the signal-to-noise ratio (S/N) in mobile instruments as a measure of sensitivity revealed a significantly lower performance compared to the benchtop lab equipment (with a ratio among medians of ~8 times lower). Overall, our study reveals not only a poor signal-to-noise ratio and poor reproducibility of the data obtained from mobile instruments, but also unfavorable results with respect to a reliable identification of substances when they are applied for complex mixtures of volatiles.
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Gul I, Zhai S, Zhong X, Chen Q, Yuan X, Du Z, Chen Z, Raheem MA, Deng L, Leeansyah E, Zhang C, Yu D, Qin P. Angiotensin-Converting Enzyme 2-Based Biosensing Modalities and Devices for Coronavirus Detection. BIOSENSORS 2022; 12:bios12110984. [PMID: 36354493 PMCID: PMC9688389 DOI: 10.3390/bios12110984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 05/30/2023]
Abstract
Rapid and cost-effective diagnostic tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are a critical and valuable weapon for the coronavirus disease 2019 (COVID-19) pandemic response. SARS-CoV-2 invasion is primarily mediated by human angiotensin-converting enzyme 2 (hACE2). Recent developments in ACE2-based SARS-CoV-2 detection modalities accentuate the potential of this natural host-virus interaction for developing point-of-care (POC) COVID-19 diagnostic systems. Although research on harnessing ACE2 for SARS-CoV-2 detection is in its infancy, some interesting biosensing devices have been developed, showing the commercial viability of this intriguing new approach. The exquisite performance of the reported ACE2-based COVID-19 biosensors provides opportunities for researchers to develop rapid detection tools suitable for virus detection at points of entry, workplaces, or congregate scenarios in order to effectively implement pandemic control and management plans. However, to be considered as an emerging approach, the rationale for ACE2-based biosensing needs to be critically and comprehensively surveyed and discussed. Herein, we review the recent status of ACE2-based detection methods, the signal transduction principles in ACE2 biosensors and the development trend in the future. We discuss the challenges to development of ACE2-biosensors and delineate prospects for their use, along with recommended solutions and suggestions.
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Affiliation(s)
- Ijaz Gul
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Shiyao Zhai
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Xiaoyun Zhong
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Qun Chen
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Xi Yuan
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Zhicheng Du
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Zhenglin Chen
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Muhammad Akmal Raheem
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Lin Deng
- Shenzhen Bay Laboratory, Shenzhen 518132, China
| | - Edwin Leeansyah
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Canyang Zhang
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
| | - Dongmei Yu
- Department of Computer Science and Technology, School of Mechanical, Electrical & Information Engineering, Shandong University, Weihai 264209, China
| | - Peiwu Qin
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China
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Hu B, Ouyang G. In situ solid phase microextraction sampling of analytes from living human objects for mass spectrometry analysis. Trends Analyt Chem 2021. [DOI: 10.1016/j.trac.2021.116368] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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5
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Marder D, Tzanani N, Baratz A, Drug E, Prihed H, Weiss S, Ben-Chetrit E, Eichel R, Dagan S, Yishai Aviram L. A multiple-method comparative study using GC-MS, AMDIS and in-house-built software for the detection and identification of "unknown" volatile organic compounds in breath. JOURNAL OF MASS SPECTROMETRY : JMS 2021; 56:e4782. [PMID: 34523187 DOI: 10.1002/jms.4782] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 06/13/2023]
Abstract
The human respiratory system is a highly complex matrix that exhales many volatile organic compounds (VOCs). Breath-exhaled VOCs are often "unknowns" and possess low concentrations, which make their analysis, peak digging and data processing challenging. We report a new methodology, applied in a proof-of-concept experiment, for the detection of VOCs in breath. For this purpose, we developed and compared four complementary analysis methods based on solid-phase microextraction and thermal desorption (TD) tubes with two GC-mass spectrometer (MS) methods. Using eight model compounds, we obtained an LOD range of 0.02-20 ng/ml. We found that in breath analysis, sampling the exhausted air from Tedlar bags is better when TD tubes are used, not only because of the preconcentration but also due to the stability of analytes in the TD tubes. Data processing (peak picking) was based on two data retrieval approaches with an in-house script written for comparison and differentiation between two populations: sick and healthy. We found it best to use "raw" AMDIS deconvolution data (.ELU) rather than its NIST (.FIN) identification data for comparison between samples. A successful demonstration of this method was conducted in a pilot study (n = 21) that took place in a closed hospital ward (Covid-19 ward) with the discovery of four potential markers. These preliminary findings, at the molecular level, demonstrate the capabilities of our method and can be applied in larger and more comprehensive experiments in the omics world.
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Affiliation(s)
- Dana Marder
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Nitzan Tzanani
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Adva Baratz
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Eyal Drug
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Hagit Prihed
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Shay Weiss
- Department of Infectious Diseases, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Eli Ben-Chetrit
- Department of Infectious Diseases, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Roni Eichel
- Stroke Unit/Neurological ICU, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Shai Dagan
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
| | - Lilach Yishai Aviram
- Department of Analytical Chemistry, Israel Institute for Biological Research (IIBR), Ness Ziona, Israel
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Yuan ZC, Hu B. Mass Spectrometry-Based Human Breath Analysis: Towards COVID-19 Diagnosis and Research. JOURNAL OF ANALYSIS AND TESTING 2021; 5:287-297. [PMID: 34422436 PMCID: PMC8364943 DOI: 10.1007/s41664-021-00194-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/25/2021] [Indexed: 12/12/2022]
Abstract
COVID-19 is a highly contagious respiratory disease that can be infected through human exhaled breath. Human breath analysis is an attractive strategy for rapid diagnosis of COVID-19 in a non-invasive way by monitoring breath biomarkers. Mass spectrometry (MS)-based approaches offer a promising analytical platform for human breath analysis due to their high speed, specificity, sensitivity, reproducibility, and broad coverage, as well as its versatile coupling methods with different chromatographic separation, and thus can lead to a better understanding of the clinical and biochemical processes of COVID-19. Herein, we try to review the developments and applications of MS-based approaches for multidimensional analysis of COVID-19 breath samples, including metabolites, proteins, microorganisms, and elements. New features of breath sampling and analysis are highlighted. Prospects and challenges on MS-based breath analysis related to COVID-19 diagnosis and study are discussed.
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Affiliation(s)
- Zi-Cheng Yuan
- Guangdong Provincial Engineering Research Center for On-line Source Apportionment System of Air Pollution, Institute of Mass Spectrometry and Atmospheric Environment, Jinan University, Guangzhou, 510632 China
| | - Bin Hu
- Guangdong Provincial Engineering Research Center for On-line Source Apportionment System of Air Pollution, Institute of Mass Spectrometry and Atmospheric Environment, Jinan University, Guangzhou, 510632 China
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7
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Ibrahim W, Cordell RL, Wilde MJ, Richardson M, Carr L, Sundari Devi Dasi A, Hargadon B, Free RC, Monks PS, Brightling CE, Greening NJ, Siddiqui S. Diagnosis of COVID-19 by exhaled breath analysis using gas chromatography-mass spectrometry. ERJ Open Res 2021; 7:00139-2021. [PMID: 34235208 PMCID: PMC8255539 DOI: 10.1183/23120541.00139-2021] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/24/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The ongoing coronavirus disease 2019 (COVID-19) pandemic has claimed over two and a half million lives worldwide so far. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is perceived to be seasonally recurrent, and a rapid noninvasive 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 The aim of this study was 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 was carried out, 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). RESULTS 81 patients were recruited between April 29 and July 10, 2020, of whom 52 out of 81 (64%) tested positive for COVID-19 by reverse transcription-polymerase chain reaction (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.
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Affiliation(s)
- Wadah Ibrahim
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
- These authors contributed equally
| | - Rebecca L. Cordell
- School of Chemistry, University of Leicester, Leicester, UK
- These authors contributed equally
| | | | - Matthew Richardson
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
| | - Liesl Carr
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
| | - Ananga Sundari Devi Dasi
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
| | - Beverley Hargadon
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
| | - Robert C. Free
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
| | - Paul S. Monks
- School of Chemistry, University of Leicester, Leicester, UK
| | - Christopher E. Brightling
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
| | - Neil J. Greening
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
| | - Salman Siddiqui
- Dept of Respiratory Sciences, University of Leicester, Leicester, UK
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre (Respiratory theme), Glenfield Hospital, Leicester, UK
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Ghosh C, Leon A, Koshy S, Aloum O, Al-Jabawi Y, Ismail N, Weiss ZF, Koo S. Breath-Based Diagnosis of Infectious Diseases: A Review of the Current Landscape. Clin Lab Med 2021; 41:185-202. [PMID: 34020759 DOI: 10.1016/j.cll.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Various analytical methods can be applied to concentrate, separate, and examine trace volatile organic metabolites in the breath, with the potential for noninvasive, rapid, real-time identification of various disease processes, including an array of microbial infections. Although biomarker discovery and validation in microbial infections can be technically challenging, it is an approach that has shown great promise, especially for infections that are particularly difficult to identify with standard culture and molecular amplification-based approaches. This article discusses the current state of breath analysis for the diagnosis of infectious diseases.
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Affiliation(s)
- Chiranjit Ghosh
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Armando Leon
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Seena Koshy
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Obadah Aloum
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Yazan Al-Jabawi
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Nour Ismail
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Zoe Freeman Weiss
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sophia Koo
- Division of Infectious Diseases, Brigham and Women's Hospital, 181 Longwood Avenue, MCP642, Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA.
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Abstract
This article reviews the many and varied mass spectrometry based responses to the SARS-CoV2 coronavirus amidst a continuing global healthcare crisis. Although RT-PCR is the most prevalent molecular based surveillance approach, improvements in the detection sensitivities with mass spectrometry coupled to the rapid nature of analysis, the high molecular precision of measurements, opportunities for high sample throughput, and the potential for in-field testing, offer advantages for characterising the virus and studying the molecular pathways by which it infects host cells. The detection of biomarkers by MALDI-TOF mass spectrometry, studies of viral peptides using proteotyping strategies, targeted LC-MS analyses to identify abundant peptides in clinical specimens, the analysis of viral protein glycoforms, proteomics approaches to understand impacts of infection on host cells, and examinations of point-of-care breath analysis have all been explored. This review organises and illustrates these applications with reference to the many studies that have appeared in the literature since the outbreak. In this respect, those studies in which mass spectrometry has a major role are the focus, and only those which have peer-reviewed have been cited.
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Affiliation(s)
- Justin H Griffin
- Infectious Disease Responses Laboratory, Prince of Wales Clinical Research Sciences, Sydney, Australia
| | - Kevin M Downard
- Infectious Disease Responses Laboratory, Prince of Wales Clinical Research Sciences, Sydney, Australia
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10
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Vandenberg O, Martiny D, Rochas O, van Belkum A, Kozlakidis Z. Considerations for diagnostic COVID-19 tests. Nat Rev Microbiol 2021; 19:171-183. [PMID: 33057203 PMCID: PMC7556561 DOI: 10.1038/s41579-020-00461-z] [Citation(s) in RCA: 447] [Impact Index Per Article: 149.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 02/07/2023]
Abstract
During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, design, development, validation, verification and implementation of diagnostic tests were actively addressed by a large number of diagnostic test manufacturers. Hundreds of molecular tests and immunoassays were rapidly developed, albeit many still await clinical validation and formal approval. In this Review, we summarize the crucial role of diagnostic tests during the first global wave of COVID-19. We explore the technical and implementation problems encountered during this early phase in the pandemic, and try to define future directions for the progressive and better use of (syndromic) diagnostics during a possible resurgence of COVID-19 in future global waves or regional outbreaks. Continuous global improvement in diagnostic test preparedness is essential for more rapid detection of patients, possibly at the point of care, and for optimized prevention and treatment, in both industrialized countries and low-resource settings.
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Affiliation(s)
- Olivier Vandenberg
- Innovation and Business Development Unit, Laboratoire Hospitalier Universtaire de Bruxelles - Universitair Laboratorium Brussel, Université Libre de Bruxelles, Brussels, Belgium.
- Center for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
- Division of Infection and Immunity, Faculty of Medical Sciences, University College London, London, UK.
| | - Delphine Martiny
- Department of Microbiology, Laboratoire Hospitalier Universtaire de Bruxelles - Universitair Laboratorium Brussel, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier Rochas
- Strategic Intelligence, Corporate Business Development, bioMérieux, Chemin de L'Orme, France
| | - Alex van Belkum
- Open Innovation and Partnerships, bioMérieux, La Balme Les Grottes, France.
| | - Zisis Kozlakidis
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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Oyewole AO, Barrass L, Robertson EG, Woltmann J, O’Keefe H, Sarpal H, Dangova K, Richmond C, Craig D. COVID-19 Impact on Diagnostic Innovations: Emerging Trends and Implications. Diagnostics (Basel) 2021; 11:182. [PMID: 33513988 PMCID: PMC7912626 DOI: 10.3390/diagnostics11020182] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/06/2023] Open
Abstract
Diagnostic testing remains the backbone of the coronavirus disease 2019 (COVID-19) response, supporting containment efforts to mitigate the outbreak. The severity of this crisis and increasing capacity issues associated with polymerase chain reaction (PCR)-based testing, accelerated the development of diagnostic solutions to meet demands for mass testing. The National Institute for Health Research (NIHR) Innovation Observatory is the national horizon scanning organization in England. Since March, the Innovation Observatory has applied advanced horizon scanning methodologies and tools to compile a diagnostic landscape, based upon data captured for molecular (MDx) and immunological (IDx) based diagnostics (commercialized/in development), for the diagnosis of SARS-CoV-2. In total we identified and tracked 1608 diagnostics, produced by 1045 developers across 54 countries. Our dataset shows the speed and scale in which diagnostics were produced and provides insights into key periods of development and shifts in trends between MDx and IDx solutions as the pandemic progressed. Stakeholders worldwide required timely and detailed intelligence to respond to major challenges, including testing capacity and regulatory issues. Our intelligence assisted UK stakeholders with assessing priorities and mitigation options throughout the pandemic. Here we present the global evolution of diagnostic innovations devised to meet changing needs, their regulation and trends across geographical regions, providing invaluable insights into the complexity of the COVID-19 phenomena.
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Affiliation(s)
- Anne O. Oyewole
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Lucy Barrass
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Emily G. Robertson
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - James Woltmann
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Hannah O’Keefe
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK
| | - Harsimran Sarpal
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Kim Dangova
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
| | - Catherine Richmond
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK
| | - Dawn Craig
- National Institute for Health Research (NIHR) Innovation Observatory, Newcastle University, Newcastle NE4 5TG, UK; (L.B.); (E.G.R.); (J.W.); (H.O.); (H.S.); (K.D.); (C.R.); (D.C.)
- Evidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle NE2 4AX, UK
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Welcome to volume 13 of Bioanalysis. Bioanalysis 2021. [DOI: 10.4155/bio-2020-0321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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