A Breath-Analysis Test for Rapid Diagnosis of COVID-19

There is an urgent need to rapidly distinguish COVID-19 from other respiratory conditions, including influenza. Point-of-care tests not requiring laboratory support will speed diagnosis and reduce exposure to those infected with the coronavirus.

In this regard, investigators at Loughborough University (United Kingdom) and collaborators at the IMSPEX Group (Abercynon, United Kingdom) and other sites in the United Kingdom and Germany evaluated the feasibility of using breath-analysis to distinguish these conditions with near-patient gas chromatography-ion mobility spectrometry (GC-IMS).

For the feasibility study, a group of 98 patients were recruited in Edinburgh, the United Kingdom, and Dortmund, Germany. Among this group, 31 patients had COVID-19, as diagnosed by RT- qPCR analysis of oral/nasal swabs. The other patients were diagnosed with asthma, exacerbation of asthma and COPD, viral pneumonia, other respiratory tract infections, and cardiac conditions.

A single breath-sample from each patient was tested for volatile organic compounds (VOCs) using the IMSPEX BreathSpec GC-IMS analyzer. Multivariate analysis identified aldehydes (ethanal, octanal), ketones (acetone, butanone), and methanol that discriminated COVID-19 from other conditions. An unidentified-feature with significant predictive power for severity/death was isolated in Edinburgh, while heptanal was identified in Dortmund. Differentiation of patients with definite diagnosis of COVID-19 from non-COVID-19 was possible with 80% and 81.5% accuracy in Edinburgh and Dortmund, respectively.

Contributing author, Dr. Paul Thomas, professor of analytical science at Loughborough University, said, "We are hugely encouraged by these findings. Employing tried and tested techniques used during the TOXI-Triage project, suggests that COVID-19 may be rapidly distinguished from other respiratory conditions. To develop this technique further larger studies are required, together with complementary GC-MS studies, to build on the data collected so far. If shown to be reliable, it offers the possibility for rapid identification or exclusion of COVID-19 in emergency departments or primary care that will protect healthcare staff, improve the management of patients, and reduce the spread of COVID-19."

The breath-analysis test for rapid diagnosis of COVID-19 was described in the October 24, 2020, online edition of the journal EClinicalMedicine.

Related Links:
Loughborough University
IMSPEX Group