Discriminatory Ability of Gas Chromatography–Ion Mobility Spectrometry to Identify Patients Hospitalized With COVID-19 and Predict Prognosis

  1. Joshua Nazareth
  2. Daniel Pan
  3. Jee Whang Kim
  4. Jack Leach
  5. James G Brosnan
  6. Adam Ahmed
  7. Emma Brodrick
  8. Paul Bird
  9. Alfian Wicaksono
  10. Emma Daulton
  11. Julian W Tang
  12. Caroline Williams
  13. Pranabashis Haldar
  14. James A Covington
  15. Manish Pareek
  16. Amandip Sahota

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Abstract

Background

Rapid diagnostic and prognostic tests for coronavirus disease (COVID-19) are urgently required. We aimed to evaluate the diagnostic and prognostic ability of breath analysis using gas chromatography–ion mobility spectrometry (GC-IMS) in hospitalized patients with COVID-19.

Methods

Between February and May 2021, we took 1 breath sample for analysis using GC-IMS from participants who were admitted to the hospital for COVID-19, participants who were admitted to the hospital for other respiratory infections, and symptom-free controls, at the University Hospitals of Leicester NHS Trust, United Kingdom. Demographic, clinical, and radiological data, including requirement for continuous positive airway pressure (CPAP) ventilation as a marker for severe disease in the COVID-19 group, were collected.

Results

A total of 113 participants were recruited into the study. Seventy-two (64%) were diagnosed with COVID-19, 20 (18%) were diagnosed with another respiratory infection, and 21 (19%) were healthy controls. Differentiation between participants with COVID-19 and those with other respiratory tract infections with GC-IMS was highly accurate (sensitivity/specificity, 0.80/0.88; area under the receiver operating characteristics curve [AUROC], 0.85; 95% CI, 0.74–0.96). GC-IMS was also moderately accurate at identifying those who subsequently required CPAP (sensitivity/specificity, 0.62/0.80; AUROC, 0.70; 95% CI, 0.53–0.87).

Conclusions

GC-IMS shows promise as both a diagnostic tool and a predictor of prognosis in hospitalized patients with COVID-19 and should be assessed further in larger studies.

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  1. Version published to 10.1093/ofid/ofac509
  2. ScreenIT

    SciScore for 10.1101/2022.02.28.22271571: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: Patients who were unable to understand and comply with the protocol, or unable or unwilling to give informed consent, were not included in the study.
    IRB: Ethics: The study had ethical approval from the West Midlands Research Ethics Committee (REC Reference 20/WM/0153).
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Analyses were performed using STATA version 14.2
    STATA
    suggested: (Stata, RRID:SCR_012763)
    (StataCorp United States) and Excel version 2016 (
    StataCorp
    suggested: (Stata, RRID:SCR_012763)
    Excel
    suggested: None

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.02.28.22271571 on medRxiv