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EBioMedicine


Title:Metabolomics of exhaled breath in critically ill COVID-19 patients: A pilot study
Author(s):Grassin-Delyle S; Roquencourt C; Moine P; Saffroy G; Carn S; Heming N; Fleuriet J; Salvator H; Naline E; Couderc LJ; Devillier P; Thevenot EA; Annane D; Garches CG; Exhalomics C;
Address:"Hopital Foch, Exhalomics(R), Departement des maladies des voies respiratoires, Suresnes, France (S.G.D., H.S., E.N., L-J.C., P.D.); Universite Paris-Saclay, UVSQ, INSERM, Infection et inflammation, Montigny le Bretonneux, France (S.G.D., P.M., N.H., D.A.); FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis) (S.G.D., H.S., E.N., L-J.C., P.D., E.T., D.A.).. Electronic address: stanislas.grassin-delyle@uvsq.fr. CEA, LIST, Laboratoire Sciences des Donnees et de la Decision, Gif-sur-Yvette, France (C.R.). Universite Paris-Saclay, UVSQ, INSERM, Infection et inflammation, Montigny le Bretonneux, France (S.G.D., P.M., N.H., D.A.); Intensive Care Unit, Raymond Poincare Hospital, Assistance Publique-Hopitaux de Paris, Garches, France (P.M., G.S., S.C., N.H., J.F., D.A.). Intensive Care Unit, Raymond Poincare Hospital, Assistance Publique-Hopitaux de Paris, Garches, France (P.M., G.S., S.C., N.H., J.F., D.A.). Hopital Foch, Exhalomics(R), Departement des maladies des voies respiratoires, Suresnes, France (S.G.D., H.S., E.N., L-J.C., P.D.); FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis) (S.G.D., H.S., E.N., L-J.C., P.D., E.T., D.A.). Departement Medicaments et Technologies pour la Sante (DMTS), Universite Paris-Saclay, CEA, INRAE, MetaboHUB, Gif-sur-Yvette, France (E.T.); FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis) (S.G.D., H.S., E.N., L-J.C., P.D., E.T., D.A.). Universite Paris-Saclay, UVSQ, INSERM, Infection et inflammation, Montigny le Bretonneux, France (S.G.D., P.M., N.H., D.A.); Intensive Care Unit, Raymond Poincare Hospital, Assistance Publique-Hopitaux de Paris, Garches, France (P.M., G.S., S.C., N.H., J.F., D.A.); FHU SEPSIS (Saclay and Paris Seine Nord Endeavour to PerSonalize Interventions for Sepsis) (S.G.D., H.S., E.N., L-J.C., P.D., E.T., D.A.)"
Journal Title:EBioMedicine
Year:2021
Volume:20201204
Issue:
Page Number:103154 -
DOI: 10.1016/j.ebiom.2020.103154
ISSN/ISBN:2352-3964 (Electronic) 2352-3964 (Linking)
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 25(th) and June 25(th), 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), Region Ile de France (SESAME 2016), and Fondation Foch"
Keywords:Aged Area Under Curve Breath Tests COVID-19/*pathology/virology Critical Illness Discriminant Analysis Female Humans Least-Squares Analysis Male Metabolomics/*methods Middle Aged Pilot Projects Principal Component Analysis Prospective Studies ROC Curve Re;
Notes:"MedlineGrassin-Delyle, Stanislas Roquencourt, Camille Moine, Pierre Saffroy, Gabriel Carn, Stanislas Heming, Nicholas Fleuriet, Jerome Salvator, Helene Naline, Emmanuel Couderc, Louis-Jean Devillier, Philippe Thevenot, Etienne A Annane, Djillali (R) eng Netherlands 2020/12/07 EBioMedicine. 2021 Jan; 63:103154. doi: 10.1016/j.ebiom.2020.103154. Epub 2020 Dec 4"

 
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