Metabolomics of exhaled breath in critically ill COVID-19 patients: A pilot study

被引:158
作者
Grassin-Delyle, Stanislas [1 ,2 ,6 ]
Roquencourt, Camille [3 ]
Moine, Pierre [2 ,5 ]
Saffroy, Gabriel [5 ]
Carn, Stanislas [5 ]
Heming, Nicholas [2 ,5 ]
Fleuriet, Jerome [5 ]
Salvator, Helene [1 ,6 ]
Naline, Emmanuel [1 ,6 ]
Couderc, Louis-Jean [1 ,6 ]
Devillier, Philippe [1 ,6 ]
Thevenot, Etienne A. [4 ,6 ]
Annane, Djillali [2 ,5 ,6 ]
机构
[1] Hop Foch, Exhalom, Dept Malad Voies Resp, Suresnes, France
[2] Univ Paris Saclay, Infect & Inflammat, UVSQ, INSERM,Montigny Bretonneux, Paris, France
[3] CEA, LIST, Lab Sci Donnees & Decis, Gif Sur Yvette, France
[4] Univ Paris Saclay, Dept Medicaments & Technol Sante DMTS, MetaboHUB, INRAE,CEA, Gif Sur Yvette, France
[5] Hop Raymond Poincare, AP HP, Intens Care Unit, Garches, France
[6] FHU SEPSIS Saclay & Paris Seine Nord Endeavour Pe, Paris, France
关键词
COVID-19; Intensive care; Mechanical ventilation; Breath analysis; Metabolomics; OXIDATIVE STRESS; ELECTRONIC NOSE; GAS; BIOMARKERS; SELECTION; SCORE;
D O I
10.1016/j.ebiom.2020.103154
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2020 The Author(s). Published by Elsevier B.V.
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页数:7
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