Abstract
Coronavirus disease 2019 (COVID-19) is probably the most commonly heard word of the last 12 months. The outbreak of this virus (SARS-CoV-2) is strongly compromising worldwide healthcare systems, social behavior, and everyone’s lives. The early diagnosis of COVID-19 and isolation of positive cases has proven to be fundamental in containing the spread of the infection. Even though the polymerase chain reaction (PCR) based methods remain the gold standard for SARS-CoV-2 detection, the urgent demand for rapid and wide-scale diagnosis precipitated the development of alternative diagnostic approaches. The millions of tests performed every day worldwide are still insufficient to achieve the desired goal, that of screening the population during daily life. Probably the most appealing approach to consistently monitor COVID-19 spread is the direct detection of SARS-CoV-2 from exhaled breath. For instance, the challenging incorporation of reliable, highly sensitive, and cost-efficient detection methods in masks could represent a breakthrough in the development of portable and noninvasive point-of-care diagnosis for COVID-19. In this perspective paper, we discuss the critical technical aspects related to the application of breath analysis in the diagnosis of viral infection. We believe that, if achieved, it could represent a game-changer in containing the pandemic spread.
Highlights
Coronavirus disease 2019 (COVID-19) is probably the most commonly heard word of the last 12 months
The majority of them are being assessed using materials extracted from blood, nasal or oral swabs, sputum, and, more recently, feces.[2−4] It is well-known that the two major ways of COVID-19 spread are airborne and contact infections/diffusion.[5,6]
The procedures used to collect exhaled breath and the low reproducibility of the results show that a lot of work is still needed to make exhaled breath analysis a robust method of detection
Summary
Rapid detection (between 10 and 20 min)[45] limitations Sample preparation Time-consuming Short self-life and limited stability over time Interferences to the signal. The viral load of SARS-CoV-2 in aerosol samples is several orders of magnitude below those in nasopharyngeal swabs, making the detection of the virus from the air in close contact with positive/acute patients more challenging.[86] The use of EBC87 solves this challenge by preconcentrating the virus and its metabolic byproducts in exhaled breath, as well as large droplets or small aerosol particles from the epithelial lining fluid to the level of detectable concentrations. We think that the analysis of VOCs in breath has the potential to detect ketogenesis and other hematologic conditions related to SARS-CoV-2 infection, ensuring rapid detection and noninvasive sample collection The introduction of sputum samples to an electrochemical sensor functionalized with multiwalled carbon nanotubes gave 97% true positive detection results within 30 s (Figure 5)
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