Analysis of Volatile Organic Compounds in the Exhaled Breath of COVID-19 Patients

Tiar Oktavian Effendi, Iin Noor Chozin, Suryanti Dwi Pratiwi, Nanik Setijowati, Arinto Yudi Ponco Wardoyo

Abstract


Background: It has been more than 2 years since COVID-19’s first cases were reported in 2019. Rapid diagnosis of COVID-19 is necessary to prevent its spread. A sample for COVID-19 testing is collected by naso-oro-pharyngeal swab. This procedure is often uncomfortable and requires a trained examiner. Exhaled breath contains thousands of volatile organic compounds (VOC), which are likely to change during infection. This study aimed to analyze the difference in VOC in the exhaled breath between COVID-19 and healthy subjects.

Methods: A cross-sectional study was carried out, recruiting 90 confirmed cases of COVID-19 and 42 healthy subjects. A sample of exhaled breath was collected by using a 500-mL airbag in both groups. The sample was analyzed using an arrayed sensor breath analyzer to quantify the concentration of CO2, C7H8, C6H14, CH2O, NH4, TVOC, NO2, PM1.0, CO, NH3 ­and Acetone.

Results: The medians of CO2, NH4, TVOC, NO2, and acetone were significantly lower in COVID-19 patients compared to healthy subjects (respectively 607.3 vs 1175.1; 0.0 vs 1.05; 0.05 vs 146.6; 0.04 vs 1.55; 0.0 vs 0.23) while C7H8, CH2O, CO, and NH3 were significantly higher (respectively 0.92 vs 0.0; 0.55 vs 0.01; 0.24 vs 0.0; 1.99 vs 0.67; all with P-value of <0.05.). Furthermore, we found NH4, acetone, NH3, and CO were positively correlated with the severity of COVID-19, while CO2 and TVOC were negatively correlated.

Conclusion: COVID-19 patients emit distinctive VOC profiles in comparison with healthy subjects, and this is related to the severity of the disease.


Keywords


COVID-19, Diagnosis of COVID-19, Volatile organic compounds

Full Text:

PDF

References


Kementerian Kesehatan Republik Indonesia. Pedoman pencegahan dan pengendalian coronavirus disease 2019 (COVID-19). Keputusan Menteri Kesehatan, 413 Indonesia; 2020.

McGill AR, Kahlil R, Dutta R, Green R, Howell M, Mohapatra S, et al. SARS–COV-2 immuno-pathogenesis and potential for diverse vaccines and therapies: Opportunities and challenges. Infect Dis Rep. 2021;13(1):102–25.

World Health Organization. WHO coronavirus (COVID-19) dashboard [Internet]. World Health Organization. 2020 [cited 2022 Oct 12]. Available from: https://covid19.who.int/

World Health Organization. Antigen-detection in the diagnosis of SARS-CoV-2 infection using rapid immunoassays: interim guidance, 11 September 2020. World Health Organization; 2020.

World Health Organization. Diagnostic testing for SARS-CoV-2: interim guidance, 11 September 2020. World Health Organization; 2020.

Föh B, Borsche M, Balck A, Taube S, Rupp J, Klein C, et al. Complications of nasal and pharyngeal swabs: A relevant challenge of the COVID-19 pandemic? Eur Respir J. 2021;57(4):2004004.

Van Oort PM, Povoa P, Schnabel R, Dark P, Artigas A, Bergmans DCJJ, et al. The potential role of exhaled breath analysis in the diagnostic process of pneumonia-a systematic review. J Breath Res. 2018;12(2):024001.

Das S, Pal S, Mitra M. Significance of exhaled breath test in clinical diagnosis: A special focus on the detection of diabetes mellitus. J Med Biol Eng. 2016;36(5):605–24.

Amann A, Costello BDL, Miekisch W, Schubert J, Buszewski B, Pleil J, et al. The human volatilome: Volatile organic compounds (VOCs) in exhaled breath, skin emanations, urine, feces and saliva. J Breath Res. 2014;8(3):034001.

Boots AW, Van Berkel JJBN, Dallinga JW, Smolinska A, Wouters EF, Van Schooten FJ. The versatile use of exhaled volatile organic compounds in human health and disease. J Breath Res. 2012;6(2):027108.

Siobal MS. Monitoring exhaled carbon dioxide. Respir Care. 2016;61(10):1397–416.

Dhont S, Derom E, Van Braeckel E, Depuydt P, Lambrecht BN. The pathophysiology of “happy” hypoxemia in COVID-19. Respir Res. 2020;21(1):198.

Effros RM, Su J, Casaburi R, Shaker R, Biller J, Dunning M. Utility of exhaled breath condensates in chronic obstructive pulmonary disease: A critical review. Curr Opin Pulm Med. 2005;11(2):135–9.

Durand S, Guillier M. Transcriptional and post-transcriptional control of the nitrate respiration in bacteria. Front Mol Biosci. 2021;8:667758.

Jimenez L, Campos Codo A, Sampaio V de S, Oliveira AER, Ferreira LKK, Davanzo GG, et al. Acid ph increases SARS-COV-2 infection and the risk of death by COVID-19. Front Med (Lausanne). 2021;8:637885.

Rodrigues R, de Oliveira SC. The impact of angiotensin-converting enzyme 2 (ACE2) expression levels in patients with comorbidities on COVID-19 severity: A comprehensive review. Microorganisms. 2021;9(8):1692.

Wang G, Xiao B, Deng J, Gong L, Li Y, Li J, et al. The role of cytochrome P450 enzymes in COVID-19 pathogenesis and therapy. Front Pharmacol. 2022;13:791922.

Office of Environmental Health Hazard Assessment. Toluene reference exposure levels. Technical support document for the derivation of noncancer reference exposure levels. 2020. p. 89.

Desai SN, Farris FF, Ray SD. Lipid peroxidation. In: Wexler P, editor. Encyclopedia of Toxicology (Third Edition). Third Edition. Oxford: Academic Press; 2014. p. 89–93.

Chernyak B V., Popova EN, Prikhodko AS, Grebenchikov OA, Zinovkina LA, Zinovkin RA. COVID-19 and oxidative stress. Biochemistry (Mosc). 2020;85(12):1543–53.

Nakamura J, Shimomoto T, Collins LB, Holley DW, Zhang Z, Barbee JM, et al. Evidence that endogenous formaldehyde produces immunogenic and atherogenic adduct epitopes. Sci Rep. 2017;7(1):10787.

Ryter SW, Sethi JM. Exhaled carbon monoxide as a biomarker of inflammatory lung disease. J Breath Res. 2007;1(2):026004.

Davis CE, Hill JE, Frank M, McCartney MM, Schivo M, Bean HD. Breath analysis for respiratory infections. Breathborne Biomarkers and the Human Volatilome. 2020;335–47.

Tubau Llopart I. Biomarkers of oxidative stress in acute respiratory distress syndrome in exhaled breath measured online by mass spectrometry [Internet] [Doctoral Thesis]. TDX (Tesis Doctorals en Xarxa). Universitat Autònoma de Barcelona; 2012 [cited 2022 Oct 10]. Available from: http://hdl.handle.net/10803/96305

Khan R, Agarwal A. Alterations in total leukocyte counts after inhalation of nitrogen dioxide gas in albino rats and modulation by vitamin c and e supplementation. Int J Curr Res. 2017;9(7):54331–3.




DOI: https://doi.org/10.36497/jri.v43i4.394

Refbacks

  • There are currently no refbacks.




Copyright (c) 2023 Tiar Oktavian Effendi, Iin Noor Chozin, Suryanti Dwi Pratiwi, Arinto Yudi Ponco Wardoyo, Nanik Setijowati


INDEXING & PARTNER

SINTA Garuda Indonesian Scientific Journal Database (ISJD) Indonesia One Search (IOS) Crossref

ROAD-ISSN Dimensions Google Scholar 

 

Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845
Email: editor@jurnalrespirologi.org


An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License

Statcounter