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Breath analysis for detection of viral infection, the current position of the field




The COVID-19 pandemic has highlighted the importance of rapid, cost effective, accurate, and non-invasive testing for viral infections. Volatile compounds (VCs) have been suggested for several decades as fulfilling these criteria. However currently very little work has been done in trying to diagnose viral infections using VCs. Much of the work carried out to date involves the differentiation of bacterial and viral sources of infection and often the detection of bacterial and viral co-infection. However, this has usually been done in vitro and very little work has involved the use of human participants. Viruses hijack the host cell metabolism and do not produce their own metabolites so identifying virus specific VCs is at best a challenging task. However, there are proteins and lipids that are potential candidates as markers of viral infection. The current understanding is that host cell glycolysis is upregulated under viral infection to increase the available energy for viral replication. There is some evidence that viral infection leads to the increase of production of fatty acids, alkanes, and alkanes related products. For instance, 2,3-butandione, aldehydes, 2,8-dimethyl-undecane and n-propyl acetate have all been correlated with viral infection. Currently, the literature points to markers of oxidative stress (e.g. nitric oxide, aldehydes etc) being the most useful in the determination of viral infection. The issue, however, is that there are also many other conditions that can lead to oxidative stress markers being produced. In this review a range of (mainly mass spectrometric) methods are discussed for viral detection in breath, including breath condensate. Currently MALDI-ToF-MS is likely to be the preferred method for the identification of viral strains and variants of those strains, however it is limited by its need for the viral strains to have been sequenced and logged in a database.


Gould, O., Ratcliffe, N., Król, E., & de Lacy Costello, B. (2020). Breath analysis for detection of viral infection, the current position of the field. Journal of Breath Research, 14(4),

Journal Article Type Review
Acceptance Date Jun 12, 2020
Online Publication Date Jul 16, 2020
Publication Date Oct 1, 2020
Deposit Date Dec 3, 2020
Journal Journal of Breath Research
Print ISSN 1752-7155
Electronic ISSN 1752-7163
Publisher IOP Publishing
Peer Reviewed Peer Reviewed
Volume 14
Issue 4
Article Number 041001
Keywords Pulmonary and Respiratory Medicine, Volatile analysis, Breath
Public URL
Additional Information Journal title: Journal of Breath Research; Article type: note; Article title: Breath analysis for detection of viral infection, the current position of the field; Copyright information: © 2020 IOP Publishing Ltd; Date received: 2020-05-11; Date accepted: 2020-06-12; Online publication date: 2020-07-16