tetano
Editor, Senior Moderator
EBioMedicine
. 2020 Dec 3;63:103154.
doi: 10.1016/j.ebiom.2020.103154. Online ahead of print.
Metabolomics of exhaled breath in critically ill COVID-19 patients: A pilot study
Stanislas Grassin-Delyle[SUP] 1 [/SUP], Camille Roquencourt[SUP] 2 [/SUP], Pierre Moine[SUP] 3 [/SUP], Gabriel Saffroy[SUP] 4 [/SUP], Stanislas Carn[SUP] 4 [/SUP], Nicholas Heming[SUP] 3 [/SUP], J?r?me Fleuriet[SUP] 4 [/SUP], H?l?ne Salvator[SUP] 5 [/SUP], Emmanuel Naline[SUP] 5 [/SUP], Louis-Jean Couderc[SUP] 5 [/SUP], Philippe Devillier[SUP] 5 [/SUP], Etienne A Th?venot[SUP] 6 [/SUP], Djillali Annane[SUP] 7 [/SUP], Garches COVID-19 Collaborative GroupRECORDS Collaborators and Exhalomics? Collaborators
Affiliations
Abstract
Background: Early diagnosis of coronavirus disease 2019 (COVID-19) is of the utmost importance but remains challenging. The objective of the current study was to characterize exhaled breath from mechanically ventilated adults with COVID-19.
Methods: In this prospective observational study, we used real-time, online, proton transfer reaction time-of-flight mass spectrometry to perform a metabolomic analysis of expired air from adults undergoing invasive mechanical ventilation in the intensive care unit due to severe COVID-19 or non-COVID-19 acute respiratory distress syndrome (ARDS).
Findings: Between March 25[SUP]th[/SUP] and June 25[SUP]th[/SUP], 2020, we included 40 patients with ARDS, of whom 28 had proven COVID-19. In a multivariate analysis, we identified a characteristic breathprint for COVID-19. We could differentiate between COVID-19 and non-COVID-19 ARDS with accuracy of 93% (sensitivity: 90%, specificity: 94%, area under the receiver operating characteristic curve: 0•94-0•98, after cross-validation). The four most prominent volatile compounds in COVID-19 patients were methylpent-2-enal, 2,4-octadiene 1-chloroheptane, and nonanal.
Interpretation: The real-time, non-invasive detection of methylpent-2-enal, 2,4-octadiene 1-chloroheptane, and nonanal in exhaled breath may identify ARDS patients with COVID-19.
Funding: The study was funded by Agence Nationale de la Recherche (SoftwAiR, ANR-18-CE45-0017 and RHU4 RECORDS, Programme d'Investissements d'Avenir, ANR-18-RHUS-0004), R?gion ?le de France (SESAME 2016), and Fondation Foch.
Keywords: Breath analysis; COVID-19; Intensive care; Mechanical ventilation; Metabolomics.
. 2020 Dec 3;63:103154.
doi: 10.1016/j.ebiom.2020.103154. Online ahead of print.
Metabolomics of exhaled breath in critically ill COVID-19 patients: A pilot study
Stanislas Grassin-Delyle[SUP] 1 [/SUP], Camille Roquencourt[SUP] 2 [/SUP], Pierre Moine[SUP] 3 [/SUP], Gabriel Saffroy[SUP] 4 [/SUP], Stanislas Carn[SUP] 4 [/SUP], Nicholas Heming[SUP] 3 [/SUP], J?r?me Fleuriet[SUP] 4 [/SUP], H?l?ne Salvator[SUP] 5 [/SUP], Emmanuel Naline[SUP] 5 [/SUP], Louis-Jean Couderc[SUP] 5 [/SUP], Philippe Devillier[SUP] 5 [/SUP], Etienne A Th?venot[SUP] 6 [/SUP], Djillali Annane[SUP] 7 [/SUP], Garches COVID-19 Collaborative GroupRECORDS Collaborators and Exhalomics? Collaborators
Affiliations
- PMID: 33279860
- DOI: 10.1016/j.ebiom.2020.103154
Abstract
Background: Early diagnosis of coronavirus disease 2019 (COVID-19) is of the utmost importance but remains challenging. The objective of the current study was to characterize exhaled breath from mechanically ventilated adults with COVID-19.
Methods: In this prospective observational study, we used real-time, online, proton transfer reaction time-of-flight mass spectrometry to perform a metabolomic analysis of expired air from adults undergoing invasive mechanical ventilation in the intensive care unit due to severe COVID-19 or non-COVID-19 acute respiratory distress syndrome (ARDS).
Findings: Between March 25[SUP]th[/SUP] and June 25[SUP]th[/SUP], 2020, we included 40 patients with ARDS, of whom 28 had proven COVID-19. In a multivariate analysis, we identified a characteristic breathprint for COVID-19. We could differentiate between COVID-19 and non-COVID-19 ARDS with accuracy of 93% (sensitivity: 90%, specificity: 94%, area under the receiver operating characteristic curve: 0•94-0•98, after cross-validation). The four most prominent volatile compounds in COVID-19 patients were methylpent-2-enal, 2,4-octadiene 1-chloroheptane, and nonanal.
Interpretation: The real-time, non-invasive detection of methylpent-2-enal, 2,4-octadiene 1-chloroheptane, and nonanal in exhaled breath may identify ARDS patients with COVID-19.
Funding: The study was funded by Agence Nationale de la Recherche (SoftwAiR, ANR-18-CE45-0017 and RHU4 RECORDS, Programme d'Investissements d'Avenir, ANR-18-RHUS-0004), R?gion ?le de France (SESAME 2016), and Fondation Foch.
Keywords: Breath analysis; COVID-19; Intensive care; Mechanical ventilation; Metabolomics.