Breath of Hope: COVID-19 breathalyzer testing in development

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Research ingenuity — and a little help from four-legged friends — promise breakthroughs in testing for COVID-19.

Audrey Odom John, MD, PhD Audrey Odom John, MD, PhD For Audrey John, MD, PhD, it started with malaria. The Chief of the Division of Pediatric Infectious Diseases at Children’s Hospital of Philadelphia (CHOP) has devoted much of her career to the study of the life-threatening illness that is spread by mosquitoes.

Children living in malaria-rife countries bear a heavy burden. Any time they run a slight fever — a classic symptom of the disease — they must have a blood test to rule out (or confirm) its presence, enduring a needle stick.

John believed there was a better way. She and her CHOP research team collected breath samples from patients with malaria and analyzed them using a mass spectrometer. This sophisticated machine is able to isolate individual compounds within a substance and, in this case, identify biomarkers of the infection. Ultimately, John believed she could develop a noninvasive “breathalyzer” type test that would spare children repeated poking and prodding.

Then along came COVID-19.

One inspired idea leads to another

As the pandemic unfolded and CHOP pivoted to focus research efforts on the virus, an idea occurred to John: Perhaps the same principles she had applied to malaria testing might have bearing on COVID-19.

Current testing methods involve a nasal swab — uncomfortable and potentially frightening for young children. And even this type of test is still not widely available. What will happen as schools and day care centers reopen? How can large groups of children be tested for their own safety and that of others?

“It is absolutely clear that we need a comprehensive testing strategy,” says John. “This is the number one health problem in the world right now.”

As a world leader in pediatric research, CHOP is uniquely positioned to quickly pursue novel investigative ideas. Marshalling CHOP’s research resources, John and her team have launched a study at CHOP to gather breath samples (along with saliva and urine) from patients who test positive for COVID-19. Again using mass spectrometry, they will attempt to isolate biomarkers of the virus.

“We have a deep well of expertise in developing diagnostics for infectious diseases,” says John. “We also have state-of-the-art equipment in place to do this work.” A simple breathalyzer test for COVID-19 may not be far off.

Sit. Stay. Heal.

Every story is better when it includes a dog — and this one is no exception. On a parallel path to her work on breath testing, John and team are using those same samples collected from patients to collaborate with the University of Pennsylvania’s Working Dog Center.

Much like airport drug-sniffing dogs, the canines in this program are trained to use their extraordinary sense of smell to detect conditions like ovarian cancer in women. John believes their olfactory prowess can be harnessed to also identify the presence of COVID-19.

Imagine a day when a classroom of children receives a visit from a furry friend, who just happens to be able to sniff out COVID-19. Suddenly, testing becomes almost fun.

John acknowledges that development of a vaccine for the virus in essential. But until one exists — and even after — “Ready access to fast, simple diagnostics will do amazing things for our ability to control the pandemic and re-open society.”