Breathomics and the Use of Exhaled Volatile Organic Compounds to Detect COVID-19

Author(s):
Kristiana Sather; Gregory Sherwood; Raia Finc; Gregory Peterson; Gregory Beilman; Elizabeth Lusczek

Background:

The COVID-19 pandemic presented many challenges to the global healthcare system. A major challenge early in the pandemic was to rapidly detect the presence of COVID-19 to allow appropriate precautions and to apply specific therapies. Volatile Organic Compounds (VOC) have been identified as potential distinguishing features in patients with a variety of underlying disorders, with the panel of compounds detected in exhaled breath serving as a chemical fingerprint.

Hypothesis:

Patients with COVID-19 would exhibit unique features in exhaled breath distinguishing them from normal controls.

Methods:

We performed a prospective observational pilot study on hospitalized, non-ventilated COVID-19 patients and healthy controls. All patients were adults and had a COVID-19 diagnosis made with molecular testing within 72 hours of the study. Patients and controls exhaled into a mask directing flow across a graphene-based sensor designed to detect the presence of disease-related VOC, resulting in real-time conversion of chemical content to electronic data. Outputs were analyzed based on detected changes in voltage and capacitance features. Linear discriminant analysis was used to compare COVID-19 patients to normal controls.

Results:

Eight patients and 10 healthy subjects completed testing with the VOC device in June-August 2020. Clinical characteristics of COVID-19 patients and volunteers are listed in the Table. Linear discriminant analysis demonstrated significant discrimination between COVID-19 patients and normal controls with area under the curve of 0.85. When control and COVID-19 patients were compared based on distinguishing characteristics, there was a significant difference in signal (p=0.0005, Figure). 

Conclusions:

In this pilot study, electronic signals from VOCs in exhaled breath distinguished patients with COVID-19 infection from healthy controls. This technology has significant potential to rapidly detect infection or other pathology in patients with acute illness. Further testing is required to evaluate clinical utility.