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. 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), Région Île de France (SESAME 2016), and Fondation Foch.
journal_name
EBioMedicinejournal_title
EBioMedicineauthors
Grassin-Delyle S,Roquencourt C,Moine P,Saffroy G,Carn S,Heming N,Fleuriet J,Salvator H,Naline E,Couderc LJ,Devillier P,Thévenot EA,Annane D,Garches COVID-19 Collaborative Group RECORDS Collaborators and Exhalomics® Collaboratordoi
10.1016/j.ebiom.2020.103154subject
Has Abstractpub_date
2021-01-01 00:00:00pages
103154issn
2352-3964pii
S2352-3964(20)30530-2journal_volume
63pub_type
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