Coronavirus breathalyzer

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A coronavirus breathalyzer is a diagnostic medical device enabling the user to test with 90% or greater accuracy the presence of severe acute respiratory syndrome coronavirus 2 in an exhaled breath. [1] As of the first half of 2020, the idea of a practical coronavirus breathalyzer was concomitantly developed by unrelated research groups in the Singapore, United States, The Netherlands, Finland, Germany, Israel, England, Australia, Indonesia, Canada, Poland and United Kingdom. [2] [3]

Contents

People with COVID-19 have higher levels of aldehydes, compounds produced when cells or tissues are damaged by inflammation, and ketones, which fits with research suggesting that the virus may damage the pancreas and cause ketosis. Diagnostics researchers hope to find the components in exhaled air that are truly characteristic of a disease and develop more specific sensors for them, This is done by studying breath samples using sensors in parallel with mass spectrometry analyses. [4]

Different diseases may cause similar breath changes. Diet can affect the chemicals someone exhales, as can smoking, alcohol consumption and medicines.

Australia

In Australia, GreyScan CEO Samantha Ollerton and Prof. Michael Breadmore of the University of Tasmania are basing a coronavirus breathalyzer on existing technology that is used around the world to detect explosives. [5]

Canada

Canary Health Technologies, headquartered in Toronto with offices in Cleveland, Ohio, is developing a breathalyzer with disposable nanosensors using AI-powered cloud-based analysis. According to a press release, clinical trials began in India during November 2020. [6] The stated goal is to develop an accurate, reasonably priced screening tool that can be used anywhere and deliver a result in less than a minute. The company postulates that analyzing volatile organic compounds in human breath could potentially detect diseases before the on-set of symptoms, earlier than currently available methods. Moreover, the cloud-based technology is designed to be used as a disease surveillance apparatus. [7] [8]

Finland

By the end of June 2020, Forum Virium Helsinki, in collaboration with Finnish software firm Deep Sensing Algorithms, funded by the Helsinki-Uusimaa Regional Council, [9] announced that testing of their device had begun with a control group in Kazakhstan, with plans to expand to the Netherlands, the United States, South Africa, Brazil and Finland throughout the summer. [10] The efficacy of the Forum Virium Helsinki / Deep Sensing Algorithms device hinges on its AI component. [11] "We are engaged in innovative cooperation with corporations to solve the coronavirus crisis, and we will help firms to use the city as a development platform. We are utilizing artificial intelligence and digitalization," said Forum Virium Helsinki CEO Mika Malin. [12]

Germany

In March 2020, the Singaporean company RAM Global conducted research in Germany in hopes of developing a one-minute breathalyzer test for SARS-CoV-2 based on terahertz time-domain spectroscopy. The company attempted to develop a disposable test kit for direct detection of COVID-19 virion particles in breath, saliva and swab samples. [13] On 31 March, RAM Global completed an initial clinical study on live patients at University Hospital Saarland. In April, the company pursued a small unknown sample study in which hospital doctors provided unknown samples in order to test accuracy in differentiating positive and negative samples. [14] The company named its product platform ThEA, or Terahertz Express Analyzer. [15]

Indonesia

A coronavirus breathalyzer, "Genose C19", developed at Gadjah Mada University, Indonesia. Screen-Shot-2021-02-07-at-21.17.00.png
A coronavirus breathalyzer, "Genose C19", developed at Gadjah Mada University, Indonesia.

Since April 2020, a team of researchers from Gadjah Mada University (UGM) has been developing an electronic nose called GeNose C19. [16] The GeNose C19 can be used as a rapid, non-invasive screening tool in less than two minutes. A profiling test was carried out at the Bhayangkara Hospital and the Covid Bambanglipuro Special Field Hospital in Yogyakarta. [17] GeNose C19 consists of gas sensors and an artificial intelligence-based pattern recognition system. The diagnostic test was carried out with the cooperation of nine multi-center hospitals. [18]

In the end of December 2020, GeNose C19 received a distribution permit from Indonesia's Health Ministry. Initially, 100 units will be released and each device will be able to perform 120 tests per day. The test is estimated to cost 15,000–25,000 Indonesian rupiah ($1–$1.8) and would take three minutes for the test and another two minutes to yield a result. Researchers hope to manufacture up to 1,000 GeNose C19 units, increasing the country's testing capabilities by 120 thousand subjects per day. [19] Moreover, they aim to manufacture 10,000 units by February 2021. [20] [21]

Israel

In Israel, it is at the photonics lab of Gabby Sarusi, professor at Ben-Gurion University of the Negev, that research is underway as of midsummer 2020. [22] Separately from Sarusi's project, in July 2020, it was reported that Israeli start-up Nanoscent in cooperation with Sheba Medical Center had devised a breathalyzer that Magen David Adom (MDA) is seeking to incorporate into existing drive-thru testing stations located throughout the country. [23]

Questionable intellectual property of Gabby Sarusi regarding this project is now under discussion in the court in Israel. [24] [25] [26]

The Netherlands

A breath test with the SpiroNose device, made by the Dutch company Breathomix, [1] has been developed and tested in collaboration with the Leiden University Medical Center (LUMC), Franciscus Gasthuis & Vlietland and the GGD Amsterdam. The breath test has been validated as a pre-screening test for people who have no or mild symptoms of COVID-19. From April 2021, the device was operational in COVID-19 test drive-ins, conferences and events, i.e. Eurovision Song Contest 2021. Subjects must abstain from alcohol for eight hours prior to taking the breath test.

The SpiroNose contains four sets of seven different sensors that can measure the mixture of volatile organic compounds (biomarkers) in the exhaled air. These VOCs provide a picture of a person's metabolism. This ‘breath profile’ is forwarded to an online analysis platform. Here the breath profile is compared with other breath profiles of people with and without a COVID-19 diagnosis and analysed by algorithms. Data-analysis involves advanced signal processing and statistics based on independent t-tests followed by linear discriminant and ROC analysis. The test result is known within minutes.

The breath test has a sensitivity/specificity for SARS-CoV-2 infection of 100/78, >99/84, 98/82% in validation, replication and asymptomatic cohorts of patients. The breath test reliably detects who is not infected. Such a subject will receive a test result immediately. Other subjects must promptly conduct a subsequent test, for example a PCR test or LAMP test. The test results can be viewed by the client and are not automatically interfaced to other databases, i.e. for public health surveillance, source and contact tracing, vaccination programs. [27] [28] In additional control tests in July 2021, it was not possible to obtain sufficiently reliable results specific for the GGD test drive-in setting. Additional investigation of the cause(s) is needed. [29]

The analysis platform is developed conform the requirements of the standard ISO 27001 (Information Security) and NEN 7510 (Information Security in Health Care). A CE marking has been requested. In the meantime, the Dutch minister has granted a CE marking exemption on 25 January 2021. The device may also be used to detect other diseases, e.g., asthma, COPD, lung cancer, interstitial lung diseases (ILD).

Poland

COVID Detector, developed by ML System in Poland. COVID Detector.jpg
COVID Detector, developed by ML System in Poland.

In February 2021, the President of Poland, Andrzej Duda, announced that ML System S. A., headquartered in Zaczernie, Poland, had successfully developed a means of analyzing a patient's breath to test for the presence of coronavirus. [30] According to an anonymous press release, test subjects exhale into a device in order to determine the presence of the coronavirus. The procedure, similar to that of a police breathalyzer, is said to take less than ten seconds. Independent clinical trials were begun in April 2021. [31] In the first half of May 2021, a brief text concerning partial results was published by ML System, stating that independent clinical trials were successful with specificity (97,15%) and accuracy/sensitivity (86,86%), for CT (Cycle Threshold) assumed at 25, which is in line with the guidelines set out by the World Health Organisation. [32] Moreover, ML System in partnership with Rzeszów–Jasionka Airport published a statement indicating their intention to test the device at the airport. [33] Similar plans exist between the manufacturer and the Warsaw Chopin Airport. [34] Two large networks of laboratories in Poland, "Diagnostyka" and "ALAB Laboratoria", have signed a letter of intent with ML System. In agreement with ALAB, the parties declared cooperation in the implementation of the product named "COVID DETECTOR" on the Polish, German and Ukrainian markets. In addition, the companies declared joint activities aimed at extending the diagnosis with the use of "COVID Detector" to include mutations of the SARS-CoV-2 virus, differentiate the stage of the disease and other pathogens, including tuberculosis. Cooperation with laboratories Diagnostyka, including detection of mutations of SARS-CoV-2 virus or other pathogens, also involves the diagnosis of cancer with the use of the device.

United Kingdom

In January 2021, Exhalation Technology Ltd (ETL) in Cambridge announced a clinical trial study for a cohort of up to 150 patients for its CoronaCheck breath test for COVID-19. [35]

United States

In June 2020, American researchers at UCLA and Ohio State University received grants to test coronavirus breathalyzer concepts, one of which could produce results in 15 seconds. The testing system would be able to take certain compounds of an individual breath to detect coronavirus. [36] “The goal in this research is to develop cheap, massively deployable, rapid diagnostic and sentinel systems for detecting respiratory illness and airborne viral threats,” says Prof. Pirouz Kavehpour of UCLA Henry Samueli School of Engineering and Applied Science, whose research team received a one-year, $150,000 research grant from the National Science Foundation. [37]

Commercial Research Developments

Technology start-up  Global e∙dentity™ founder Dr. Robert Adams first discussed chemosensory biometrics detection during a TEDx talk in Norwich England July 2019 and by February 2020 the company had focused its chemosensory detection developments on the emerging SARS-CoV-2 (Covid-19) pandemic. The team discovered that it could distinguish between the odor of individuals with asymptomatic or mild symptomatic SARS-CoV-2 infection and uninfected individuals, essentially they had identified the chemical odor signature associated with the metabolism of Covid-19 on a human or non-human. The team went on to tune the associated AI algorithms to achieve an almost faultless 100% detection accuracy and to file and be granted the first Covid detection patent 29 Dec 2020:U.S. Patent number 10880303. Global e∙dentity™ fourth patent issued in two years.

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A breath test is a type of test performed on air generated from the act of exhalation.

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Lateral flow test Immunochromatographic testing devices

Lateral flow tests (LFTs), also known as lateral flow immunochromatographic assays or rapid tests, are simple devices intended to detect the presence of a target substance in a liquid sample without the need for specialized and costly equipment. These tests are widely used in medical diagnostics for home testing, point of care testing, or laboratory use. For instance, the home pregnancy test is an LFT that detects a specific hormone. These tests are simple, economic and generally show results in around five to 30 minutes. Many lab-based applications increase the sensitivity of simple LFTs by employing additional dedicated equipment.

Breath diagnostics involves the analysis of a sample of human breath to monitor, diagnose, and detect diseases and conditions. Besides its primary constituents – nitrogen, oxygen, carbon dioxide and water vapour – exhaled human breath contains over one thousand other compounds at trace levels. Many of these species are formed as the by-products of metabolic processes and can be indicative of a number of different diseases and conditions. Examples of such biomarkers are outlined below:

Breath gas analysis is a method for gaining information on the clinical state of an individual by monitoring volatile organic compounds (VOCs) present in the exhaled breath. Exhaled breath is naturally produced by the human body through expiration and therefore can be collected in non-invasively and in an unlimited way. VOCs in exhaled breath can represent biomarkers for certain pathologies. Breath gas concentration can then be related to blood concentrations via mathematical modeling as for example in blood alcohol testing. There are various techniques that can be employed to collect and analyze exhaled breath. Research on exhaled breath started many years ago, there is currently limited clinical application of it for disease diagnosis. However, this might change in the near future as currently large implementation studies are starting globally.

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References

  1. 1 2 Anthes, E., "A Covid Test as Easy as Breathing", The New York Times, July 11, 2021.
  2. Staff, "Coronavirus-Detecting Breathing Device Could Potentially Give a Diagnosis in Less than One Minute", HospiMedica International, April 20, 2020.
  3. Anon, "New coronavirus test that is eight times faster can help locate asymptomatic carriers", EurekAlert!, April 20, 2020.
  4. Forget throat swabs: Dutch company claims its breathalyzer can help sniff out COVID-19
  5. Hogan, M., & Woolley, S., "The world-first 'on the spot' COVID test that could detect the virus in minutes", Seven News , June 30, 2020.
  6. Anon., "Ground Breaking Human Trial for COVID-19 Ultra-Rapid Breath Test Begins in India", PR Newswire, December 7, 2020.
  7. Makoni, M., In South Africa, COVID-19 "Breath Test Trial Set for June", The Scientist, June 15, 2020.
  8. Ebrahim, Z., "Trial for Covid-19 rapid breath test – that delivers results in under 5 minutes, to start in SA", News24 , May 29, 2020.
  9. Anon, "Finnish companies develop instant COVID-19 breathalyzer", China Internet Information Center, June 29, 2020.
  10. Salomaa, M., "Laakson terveysasemalla alkavat uuden laitteen puhallustestit koronaviruksen tunnistamiseksi", Helsingin Sanomat , June 28, 2020.
  11. Anon, "Helsinki to trial coronavirus breathalyser", Yle, June 29, 2020.
  12. News desk, "Finland to trial instant coronavirus breathalyzer", Daily Finland, June 29, 2020.
  13. Deters, Jannik. "Coronavirus-Schnelltest: Saarländer Firma verspricht Testergebnis in zwei Minuten". www.wiwo.de (in German). Retrieved 2020-08-23.
  14. Deters, Jannik. "Uniklinik im Saarland: Wie sicher ist der Zwei-Minuten-Test auf Corona?". www.wiwo.de (in German). Retrieved 2020-08-23.
  15. Anon., "RAM Group Germany Awarded XPRIZE for Rapid COVID Testing Using Sensors Instead of PCR Tests—Ushering in New Age of Digital Diagnostics", Digital Journal, April 20, 2021.
  16. Staff, "Genosvid Diagnostic Test for Early Detection of COVID-19", ClinicalTrials.gov, September 22, 2020.
  17. Alfarizi, Moh Khory (24 September 2020). "UGM Develops COVID-19 'Breath Detector' with 97 Percent Accuracy Claim". Tempo. Translated by Nugraha, Ricky Mohammad. Retrieved 28 December 2020.
  18. Permatasari, Adinda; Edi, Cahyo (27 October 2020). "Alat Deteksi COVID-19 Buatan UGM Diuji Coba dengan 9 Rumah Sakit" [UGM's COVID-19 Detection Device Trialed by 9 Hospitals]. VIVA.co.id (in Indonesian). Retrieved 28 December 2020.
  19. "Indonesia's AI-Powered Covid-19 Test GeNose Cleared for Public Use". Jakarta Globe . December 27, 2020. Retrieved December 27, 2020.
  20. Satria. "GeNose UGM Dapatkan Izin Edar dan Siap Dipasarkan" [UGM's Genose Receives Distribution Permit, Ready to Launch]. Gadjah Mada University (in Indonesian). December 26, 2020. Retrieved December 27, 2020.
  21. Direktorat Pengembangan Usaha dan Inkubasi Universitas Gadjah Mada. "FAQ GENOSE C19" [FAQ GENOSE C19]. Gadjah Mada University (in Indonesian). January 14, 2021. Retrieved February 9, 2021.
  22. Zeldovich, L., "Will Travel Be Safer By 2022?", BBC News, June 22, 2020.
  23. Keyser, Z., "Israeli technology that can 'sniff out' COVID-19 infections begins trials", The Jerusalem Post , July 1, 2020.
  24. Dobrovitsky, L., "One-minute Covid-19 detector at center of bitter legal battle", Calcalist , July 20, 2020.
  25. Anon., "Israeli One-Minute Coronavirus Detector At Center Of Aggressive Legal Battle", Jewish Business News , July 20th, 2020.
  26. Rutman, D., "Israeli One-Minute Coronavirus Detector at Center of Aggressive Legal Battle", Jewish Review , July 20, 2020.
  27. Vries, R. de; Vigeveno, R. M. (February 16, 2021). "Ruling out SARS-CoV-2 infection using exhaled breath analysis by electronic nose in a public health setting". medRxiv: 2021.02.14.21251712. doi:10.1101/2021.02.14.21251712. S2CID   231933501 . Retrieved April 22, 2021.
  28. Anon. (March 18, 2021). "SpiroNose: The electronic nose that knows about Covid-19". Healthcare in Europe . Retrieved April 22, 2021.
  29. Nederlandse corona-blaastest ‘waar heel de wereld jaloers op is’ werkt niet goed: GGD weigert gebruik
  30. Anon., "Poles have created a device that detects coronavirus from breath", Business Insider , February 15, 2021.
  31. Anon., "A breakthrough discovery of Polish scientists—their device detects coronavirus from the breath", Poland Daily, February 12, 2021.
  32. Anon., "Covid Detector firmy ML System ma specyficzność 97,15 proc. i czułość 86,86 proc.", www.bankier.pl (in Polish), May 13, 2021.
  33. Anon., "Port Lotniczy Rzeszów-Jasionka jako pierwsze lotnisko regionalne przetestuje innowacyjną technologię wykrywania zakażeń wirusem SARS-CoV-2", Rzeszów–Jasionka Airport (in Polish), May 12, 2021.
  34. Anon., "Koronawirus w Polsce. Chcą testować Covid Detector na Lotnisku Chopina", www.money.pl (in Polish), April 23, 2021.
  35. "New 5-minute Covid-19 test based on breath now in clinical trials". Cambridge Independent. January 15, 2021. Retrieved April 22, 2021.
  36. Young, J., "Sacramento Kings exploring breathalyzer concept to detect Covid-19, team owner says", CNBC, June 15, 2020.
  37. Staff, "Team to Develop Breathalyzer-Like Diagnostic Test for COVID-19", ScienceBlog, May 21, 2020.