Abstract

Breath volatile organics (VOCs) may provide immediate information on infection mechanisms and host response. We conducted real-time mass-spectrometry based breath profiling in 708 non-preselected consecutive subjects in the screening scenario of a COVID-19 test center. Recruited subjects were grouped based on PCR confirmed infection status and presence or absence of flu like symptoms. Exhaled VOC profiles of SARS-CoV-2 positive cases (n=36) differed from healthy (n=256) and those with other respiratory infections (n=416). Concentrations of most VOCs were supressed in COVID-19. VOC concentrations also differed between symptomatic and asymptomatic cases. Breath markers mirror effects of infections onto host’s cellular metabolism and microbiome. Down-regulation of specific VOCs were attributed to suppressive effects of SARS-CoV-2 onto gut or pulmonary microbial metabolism. Breath analysis holds potential for monitoring SARS-CoV-2 infections rather than for primary diagnosis. Breath profiling offers unconventional insight into host-virus cross-talk and infection microbiology and enables non-invasive assessment of disease manifestation.

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