COVID-19 Testing

Can COVID-19 Be Detected Using a Breath Test?

BACKGROUND AND PURPOSE:

Ruszkiewicz et al. (EClinical Medicine, 2020) examined the feasibility of using breath analysis to distinguish COVID-19 from other respiratory conditions

Independent observational prevalence studies
Setting
- UK and Germany
Participants
- Adult patients presenting at hospital for possible COVID-19
Study design
- Participants gave a single breath-sample for analysis by gas chromatography-ion mobility spectrometry (GC-IMS)
- SARS-CoV-2 presence was determined using PCR of oral/nasal swabs
- COVID-19 breath-biomarkers were identified by multi-variate analysis and comparison to GC-IMS databases
- COVID-19 breath-score based on the relative abundance of a panel of volatile organic compounds

98 patients
- UK COVID-19 positive: 63.6%
- Germany COVID-19 positive: 15.4%
- Other non-COVID diagnoses: Asthma | COPD | Bacterial pneumonia | Cardiac conditions
The following volatile organic compounds could discriminate between COVID-19 and other respiratory conditions
- Aldehydes (ethanal, octanal)
- Ketones (acetone, butanone)
- Methanol
Differentiation of patients who were positive for COVID-19 from those who were negative was possible with 80% and 81.5% accuracy (UK and Germany, respectively)
- UK
  - Sensitivity: 82.4%
  - Specificity: 75%
  - Area-under-the-receiver- operator-characteristic (ROC) 0.87 (95% CI, 0.67 to 1)
- Germany
  - Sensitivity: 90%
  - Specificity: 80%
  - AUROC 0.91 (95% CI, 0.87 to 1)

COVID-19 patients could be distinguished from patients with other respiratory conditions using breath analysis
The marker compounds identified were consistent with breath biochemistry that would be altered by ketosis, GI abnormalities, and inflammatory processes

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