Rapid point-of-care detection of SARS-CoV-2 infection in exhaled breath using ion mobility spectrometry: a pilot study.


Journal

European journal of medical research
ISSN: 2047-783X
Titre abrégé: Eur J Med Res
Pays: England
ID NLM: 9517857

Informations de publication

Date de publication:
02 Sep 2023
Historique:
received: 24 02 2023
accepted: 12 08 2023
medline: 4 9 2023
pubmed: 3 9 2023
entrez: 2 9 2023
Statut: epublish

Résumé

An effective testing strategy is essential for pandemic control of the novel Coronavirus disease 2019 (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Breath gas analysis can expand the available toolbox for diagnostic tests by using a rapid, cost-beneficial, high-throughput point-of-care test. We conducted a bi-center clinical pilot study in Germany to evaluate breath gas analysis using multi-capillary column ion mobility spectrometry (MCC-IMS) to detect SARS-CoV-2 infection. Between September 23, 2020, and June 11, 2021, breath gas measurements were performed on 380 patients (SARS-CoV-2 real-time polymerase chain reaction (PCR) positive: 186; PCR negative: 194) presenting to the emergency department (ED) with respiratory symptoms. Breath gas analysis using MCC-IMS identified 110 peaks; 54 showed statistically significant differences in peak intensity between the SARS-CoV-2 PCR-negative and PCR-positive groups. A decision tree analysis classification resulted in a sensitivity of 83% and specificity of 86%, but limited robustness to dataset changes. Modest values for the sensitivity (74%) and specificity (52%) were obtained using linear discriminant analysis. A systematic search for peaks led to a sensitivity of 77% and specificity of 67%; however, validation by transferability to other data is questionable. Despite identifying several peaks by MCC-IMS with significant differences in peak intensity between PCR-negative and PCR-positive samples, finding a classification system that allows reliable differentiation between the two groups proved to be difficult. However, with some modifications to the setup, breath gas analysis using MCC-IMS may be a useful diagnostic toolbox for SARS-CoV-2 infection. This study was registered at ClinicalTrials.gov on September 21, 2020 (NCT04556318; Study-ID: HC-N-H-2004).

Sections du résumé

BACKGROUND BACKGROUND
An effective testing strategy is essential for pandemic control of the novel Coronavirus disease 2019 (COVID-19) caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Breath gas analysis can expand the available toolbox for diagnostic tests by using a rapid, cost-beneficial, high-throughput point-of-care test. We conducted a bi-center clinical pilot study in Germany to evaluate breath gas analysis using multi-capillary column ion mobility spectrometry (MCC-IMS) to detect SARS-CoV-2 infection.
METHODS METHODS
Between September 23, 2020, and June 11, 2021, breath gas measurements were performed on 380 patients (SARS-CoV-2 real-time polymerase chain reaction (PCR) positive: 186; PCR negative: 194) presenting to the emergency department (ED) with respiratory symptoms.
RESULTS RESULTS
Breath gas analysis using MCC-IMS identified 110 peaks; 54 showed statistically significant differences in peak intensity between the SARS-CoV-2 PCR-negative and PCR-positive groups. A decision tree analysis classification resulted in a sensitivity of 83% and specificity of 86%, but limited robustness to dataset changes. Modest values for the sensitivity (74%) and specificity (52%) were obtained using linear discriminant analysis. A systematic search for peaks led to a sensitivity of 77% and specificity of 67%; however, validation by transferability to other data is questionable.
CONCLUSIONS CONCLUSIONS
Despite identifying several peaks by MCC-IMS with significant differences in peak intensity between PCR-negative and PCR-positive samples, finding a classification system that allows reliable differentiation between the two groups proved to be difficult. However, with some modifications to the setup, breath gas analysis using MCC-IMS may be a useful diagnostic toolbox for SARS-CoV-2 infection.
TRIAL REGISTRATION BACKGROUND
This study was registered at ClinicalTrials.gov on September 21, 2020 (NCT04556318; Study-ID: HC-N-H-2004).

Identifiants

pubmed: 37660038
doi: 10.1186/s40001-023-01284-3
pii: 10.1186/s40001-023-01284-3
pmc: PMC10474630
doi:

Banques de données

ClinicalTrials.gov
['NCT04556318']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

318

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Florian Voit (F)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany. florian.voit@mri.tum.de.

J Erber (J)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

M Feuerherd (M)

Institute of Virology, Helmholtz Center Munich, TUM, School of Medicine, Munich, Germany.
Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA.

H Fries (H)

B. Braun Melsungen AG, Melsungen, Germany.

N Bitterlich (N)

ABX-CRO Advanced Pharmaceutical Services Forschungsgesellschaft mbH, Dresden, Germany.

E Diehl-Wiesenecker (E)

Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.

S Gladis (S)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

J Lieb (J)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

U Protzer (U)

Institute of Virology, Helmholtz Center Munich, TUM, School of Medicine, Munich, Germany.
German Center for Infection Research (DZIF), Munich Partner Site, Munich, Germany.

J Schneider (J)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

F Geisler (F)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

R Somasundaram (R)

Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.

R M Schmid (RM)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

W Bauer (W)

Department of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.

C D Spinner (CD)

Department of Internal Medicine II, University Hospital Rechts Der Isar, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
German Center for Infection Research (DZIF), Munich Partner Site, Munich, Germany.

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