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Metabolomics of exhaled breath in critically ill COVID-19 patients: A pilot study

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 25th and June 25th, 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.
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https://hal-cea.archives-ouvertes.fr/cea-03086093
Contributor : Marie-France Robbe <>
Submitted on : Tuesday, December 22, 2020 - 11:57:35 AM
Last modification on : Saturday, July 3, 2021 - 12:28:55 AM

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Stanislas Grassin-Delyle, Camille Roquencourt, Pierre Moine, Gabriel Saffroy, Stanislas Carn, et al.. Metabolomics of exhaled breath in critically ill COVID-19 patients: A pilot study. EBioMedicine, Elsevier, 2021, 63, pp.103154. ⟨10.1016/j.ebiom.2020.103154⟩. ⟨cea-03086093⟩

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