Advertisement

Efficient Detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) from Exhaled Breath

Published:September 29, 2021DOI:https://doi.org/10.1016/j.jmoldx.2021.09.005
      Severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) is transmitted through airborne particles in exhaled breath, causing severe respiratory disease, coronavirus disease–2019 (COVID-19), in some patients. Samples for SARS-CoV-2 testing are typically collected by nasopharyngeal swab, with the virus detected by PCR; however, patients can test positive for 3 months after infection. Without the capacity to assay SARS-CoV-2 in breath, it is not possible to understand the risk for transmission from infected individuals. To detect virus in breath, the Bubbler—a breathalyzer that reverse-transcribes RNA from SARS-CoV-2 particles into a sample-specific barcoded cDNA—was developed. In a study of 70 hospitalized patients, the Bubbler was both more predictive of lower respiratory tract involvement (abnormal chest X-ray) and less invasive than alternatives. Samples tested using the Bubbler were threefold more enriched for SARS-CoV-2 RNA than were samples from tongue swabs, implying that virus particles were being directly sampled. The barcode-enabled Bubbler was used for simultaneous diagnosis in large batches of pooled samples at a lower limit of detection of 334 genomic copies per sample. Diagnosis by sequencing can provide additional information, such as viral load and strain identity. The Bubbler was configured to sample nucleic acids in water droplets circulating in air, demonstrating its potential in environmental monitoring and the protective effect of adequate ventilation.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal

      Subscribe:

      Subscribe to The Journal of Molecular Diagnostics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Duguid J.P.
        The size and the duration of air-carriage of respiratory droplets and droplet-nuclei.
        J Hyg. 1946; 44: 471-479
        • Asadi S.
        • Wexler A.S.
        • Cappa C.D.
        • Barreda S.
        • Bouvier N.M.
        • Ristenpart W.D.
        Aerosol emission and superemission during human speech increase with voice loudness.
        Sci Rep. 2019; 9: 2348
        • Pasomsub E.
        • Watcharananan S.P.
        • Boonyawat K.
        • Janchompoo P.
        • Wongtabtim G.
        • Suksuwan W.
        • Sungkanuparph S.
        • Phuphuakrat A.
        Saliva sample as a non-invasive specimen for the diagnosis of coronavirus disease 2019: a cross-sectional study.
        Clin Microbiol Infect. 2021; 27: 285
        • Wölfel R.
        • Corman V.M.
        • Guggemos W.
        • Seilmaier M.
        • Zange S.
        • Müller M.A.
        • Niemeyer D.
        • Jones T.C.
        • Vollmar P.
        • Rother C.
        • Hoelscher M.
        • Bleicker T.
        • Brünink S.
        • Schneider J.
        • Ehmann R.
        • Zwirglmaier K.
        • Drosten C.
        • Wendtner C.
        Virological assessment of hospitalized patients with COVID-2019.
        Nature. 2020; 581: 465-469
        • Yan J.
        • Grantham M.
        • Pantelic J.
        • Bueno de Mesquita P.J.
        • Albert B.
        • Liu F.
        • Ehrman S.
        • Milton D.K.
        • EMIT Consortium
        Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community.
        Proc Natl Acad Sci U S A. 2018; 115: 1081-1086
        • Charlson E.S.
        • Bittinger K.
        • Haas A.R.
        • Fitzgerald A.S.
        • Frank I.
        • Yadav A.
        • Bushman F.D.
        • Collman R.G.
        Topographical continuity of bacterial populations in the healthy human respiratory tract.
        Am J Respir Crit Care Med. 2011; 184: 957-963
        • Hermans C.
        • Bernard A.
        Lung epithelium-specific proteins: characteristics and potential applications as markers.
        Am J Respir Crit Care Med. 1999; 159: 646-678
        • Li N.
        • Wang X.
        • Lv T.
        Prolonged SARS-CoV-2 RNA shedding: not a rare phenomenon.
        J Med Virol. 2020; 92: 2286-2287
        • Yu F.
        • Yan L.
        • Wang N.
        • Yang S.
        • Wang L.
        • Tang Y.
        • Gao G.
        • Wang S.
        • Ma C.
        • Xie R.
        • Wang F.
        • Tan C.
        • Zhu L.
        • Guo Y.
        • Zhang F.
        Quantitative detection and viral load analysis of SARS-CoV-2 in infected patients.
        Clin Infect Dis. 2020; 71: 793-798
        • Tu Y.
        • Jennings R.
        • Hart B.
        • Cangelosi G.A.
        • Wood R.C.
        • Wehber K.
        • Verma P.
        • Vojta D.
        • Berke E.M.
        Swabs collected by patients or health care workers for SARS-CoV-2 testing.
        N Engl J Med. 2020; 383: 494-496