Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients

<h4>Background</h4> 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 vol...

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Autores principales:	Matthew C. Exline, Milutin Stanacevic, Andrew S. Bowman, Pelagia-Irene Gouma
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bfb814b5c5b247d99fa6e60c93584816
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spelling	oai:doaj.org-article:bfb814b5c5b247d99fa6e60c935848162021-11-04T06:49:39ZExhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients1932-6203https://doaj.org/article/bfb814b5c5b247d99fa6e60c935848162021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553051/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> 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. <h4>Methods and findings</h4> 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. <h4>Conclusions</h4> The implication of this breath tester technology for the rapid screening for COVID-19 and potentially detection of other infectious diseases in the future.Matthew C. ExlineMilutin StanacevicAndrew S. BowmanPelagia-Irene GoumaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matthew C. Exline Milutin Stanacevic Andrew S. Bowman Pelagia-Irene Gouma Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients
description	<h4>Background</h4> 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. <h4>Methods and findings</h4> 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. <h4>Conclusions</h4> The implication of this breath tester technology for the rapid screening for COVID-19 and potentially detection of other infectious diseases in the future.
format	article
author	Matthew C. Exline Milutin Stanacevic Andrew S. Bowman Pelagia-Irene Gouma
author_facet	Matthew C. Exline Milutin Stanacevic Andrew S. Bowman Pelagia-Irene Gouma
author_sort	Matthew C. Exline
title	Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients
title_short	Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients
title_full	Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients
title_fullStr	Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients
title_full_unstemmed	Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients
title_sort	exhaled nitric oxide detection for diagnosis of covid-19 in critically ill patients
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/bfb814b5c5b247d99fa6e60c93584816
work_keys_str_mv	AT matthewcexline exhalednitricoxidedetectionfordiagnosisofcovid19incriticallyillpatients AT milutinstanacevic exhalednitricoxidedetectionfordiagnosisofcovid19incriticallyillpatients AT andrewsbowman exhalednitricoxidedetectionfordiagnosisofcovid19incriticallyillpatients AT pelagiairenegouma exhalednitricoxidedetectionfordiagnosisofcovid19incriticallyillpatients
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Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients

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