Department of Internal Medicine, Division Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America.
Department of Electrical & Computer Engineering, Stony Brook University, Stony Brook, New York, The United States of America.
PLoS One. 2021 Oct 28;16(10):e0257644. doi: 10.1371/journal.pone.0257644. eCollection 2021.
COVID-19 may present with a variety of clinical syndromes, however, the upper airway and the lower respiratory tract are the principle sites of infection. Previous work on respiratory viral infections demonstrated that airway inflammation results in the release of volatile organic compounds as well as nitric oxide. The detection of these gases from patients' exhaled breath offers a novel potential diagnostic target for COVID-19 that would offer real-time screening of patients for COVID-19 infection.
We present here a breath tester utilizing a catalytically active material, which allows for the temporal manifestation of the gaseous biomarkers' interactions with the sensor, thus giving a distinct breath print of the disease. A total of 46 Intensive Care Unit (ICU) patients on mechanical ventilation participated in the study, 23 with active COVID-19 respiratory infection and 23 non-COVID-19 controls. Exhaled breath bags were collected on ICU days 1, 3, 7, and 10 or until liberation from mechanical ventilation. The breathalyzer detected high exhaled nitric oxide (NO) concentration with a distinctive pattern for patients with active COVID-19 pneumonia. The COVID-19 "breath print" has the pattern of the small Greek letter omega (). The "breath print" identified patients with COVID-19 pneumonia with 88% accuracy upon their admission to the ICU. Furthermore, the sensitivity index of the breath print (which scales with the concentration of the key biomarker ammonia) appears to correlate with duration of COVID-19 infection.
The implication of this breath tester technology for the rapid screening for COVID-19 and potentially detection of other infectious diseases in the future.
COVID-19 可能表现出多种临床综合征，但上呼吸道和下呼吸道是感染的主要部位。先前关于呼吸道病毒感染的研究表明，气道炎症会导致挥发性有机化合物和一氧化氮的释放。从患者呼出的气体中检测到这些气体为 COVID-19 提供了一个新的潜在诊断靶点，可以实时筛查 COVID-19 感染患者。
我们在这里介绍一种利用催化活性材料的呼吸测试器，该材料允许气体生物标志物与传感器相互作用的时间表现，从而为疾病提供独特的呼吸特征。共有 46 名接受机械通气的重症监护病房 (ICU) 患者参与了这项研究，其中 23 名患有活动性 COVID-19 呼吸道感染，23 名非 COVID-19 对照组。在 ICU 第 1、3、7 和 10 天或直至脱离机械通气时收集呼出的呼吸袋。呼气分析仪检测到患有活动性 COVID-19 肺炎的患者呼出的一氧化氮 (NO) 浓度较高，且具有独特的模式。COVID-19 的“呼吸特征”具有小写希腊字母 omega (ω) 的模式。COVID-19“呼吸特征”在患者入住 ICU 时可准确识别出 88%的 COVID-19 肺炎患者。此外，呼吸特征的灵敏度指数（与关键生物标志物氨的浓度成比例）似乎与 COVID-19 感染的持续时间相关。
这种呼吸测试器技术对于 COVID-19 的快速筛查以及未来潜在的其他传染病检测具有重要意义。
