Transcriber: Ainsley Mclaughlin Reviewer: Amanda Zhu
We have been living with COVID-19 for a year now.
This is a terrible disease
that has disrupted our lives all over the globe.
Recently, I was told
that I might have been exposed to COVID-19,
so I went and I had the nasal swab
and then I had to self-quarantine
for 10 days.
And this process sounds familiar,
doesn't it?
What if I were to tell you that I didn’t have to wait
for the few days for the results from the initial swab to come back,
because I knew I didn’t have COVID by exhaling once into a mouthpiece
and within 15 seconds, getting the results?
Sounds like magic, right?
Wrong.
I am Pelagia Gouma and a Professor of Materials Science and Engineering
at the Ohio State University.
The breath test for COVID-19 is my brainchild,
and it has been 20 years in the making.
I was a young assistant professor at SUNY Stony Brook,
and that was around the year 2000,
and I was working with novel materials for chemical sensors.
Now, there was a lot of controversy
in the community, in my research community,
because they could not agree on which chemical was detected
by a simple material of a fixed composition.
Now, we all know that if everything is the same in an experiment,
then the outcome should be the same.
So something was obviously missing.
Then I realized what was missing is the community
didn’t account for the variations in the crystal structure of the materials
for a given composition.
There is a technical term for this.
It’s called polymorphism,
and it’s used to indicate how materials change their crystal structure
and the arrangement of the atoms in space
even for a given fixed composition.
And you see the slide from left to the right here:
three different polymorphs of a simple compound
that is tungsten trioxide.
They have different arrangements of the atoms in space,
they have different morphologies,
and therefore, they have unique properties.
So I took advantage of these unique properties of polymers,
and I set out to make a career by making very selective chemical sensors
that were specific to a given chemical.
The first breakthrough was when I discovered and invented
and I demonstrated a chemical sensor
that was detecting ammonia gas in a very complex environment.
The target application was for the Ford Motor Company
to install it in the exhaust of automobiles,
which is a very, very complex chemical environment.
Now, this was the first of its kind as a sensor
because it utilized materials
that changed the electrical resistance in the presence of a particular gas,
that was ammonia,
and it was doing that very, very fast.
Now, like I said, breath is a very complex mixture,
like automotive exhaust.
And I was walking one day into a Home Bookstore,
and what I noticed was a gadgety thing
like this device that you see in the bottom of the screen
and that was the alcohol breathalyzer,
you know, the one that you exhale to tell you if you’ve been intoxicated.
What struck me was that this was a very small portable device,
easy to use,
and it was utilizing
the same type of sensors I was developing in my research.
The only difference was these were generic ones
responding to many different gases,
whereas I was developing very, very specific ones for a given chemical.
What if I were to use my selective ammonia sensor
to be used for detecting ammonia in breath,
what if I were to make a medical device out of it?
And this is how I set out to start studying breath-based diagnostics.
So the way the breathalyzers work is, as you see in this slide,
you capture a breath, a single exhale.
There are 1,000 compounds in that, but you look for a single one,
which we call a biomarker.
So if biomarker is that chemical in the breath that detects a disease
and signals a disease or a metabolic malfunction.
And here you see, after you detect the ammonia,
you measure the concentration and you quantify it,
and if it’s in the normal range, someone is healthy.
If it is not, someone has a disease.
In this case, ammonia is a biomarker for renal diseases.
So then, over the course of many, many years,
I have published a lot of papers
and I have received a lot of patents on this work
by developing one sensor for one biomarker
for one type of disease.
And the way, again, this breathalyzer of a sensor concept works
is, as you see in the video here,
you only get specific molecules of the specific compound
to interact with the material.
Just to give you an example,
we were working with Group A materials, that targeted the nitric oxide,
which is a biomarker for asthma and airway diseases.
We have one type of portable hand-held breathalyzer.
I talked about the ammonia before.
Then acetone is one other biomarker for metabolic disorders and for diabetes.
And you use a different type group of materials for that.
And over the course of many, many years,
I have made one sensor, one biomarker, one device.
The next step is we’re looking at different compounds
and looking at different diseases.
How about infectious diseases?
Which are very complex ones,
so you cannot really identify them with a single biomarker.
The idea there is this compound,
these diseases give you a signature in the breath
like we humans have a signature that identify us.
In a similar way, we have a signature -
the diseases have a signature in the breath,
which is manifested by the type of the biomarker
and its relative consideration.
And once biomarkers for a flu emerge,
I was able to demonstrate the breathalyzer for flu.
And that was around the year 2017,
and it was very well received by the research community
and got a lot of attention by the press too.
Fast-forward now to February of 2010,
when I received a phone call from the White House.
They asked me if I can modify my breathalyzer for flu
to detect COVID-19.
That was the most exhilarating time for myself and for my research group
because now we were invited,
we were called to contribute to the fight against this terrible disease
and doing that using my own technology,
which was amazing.
At the same time, it was extremely challenging
because nobody knew much about SARS‑CoV‑2 or COVID-19 at the time.
So I set out to find out biomarkers in the breath for the disease
by finding the similarities and the differences
between COVID-19 and the flu.
So very soon I had identified a few chemicals
that we can target in the breath,
and then I had to make sensors out of them,
and then I had to make breathalyzers out of them.
But of course, every time you do research, you have to have funding.
So we went to the National Science Foundation
and we received a grant for this potentially transformative idea,
which is the breath test for COVID-19.
And the world took notice.
So what happened?
The challenges continue because now we are in the middle of the pandemic,
and of course, now we are in lockdown,
so we had to get special permission by the university
for myself and two of my senior graduate students to go and work in the lab
and really put ourselves out there.
We spent a lot of time, we made a lot of effort
and we started making all these sensors that detected these biomarkers.
We had to validate them with gases that mimic human breath.
And when we were ready for clinical testing,
we got out there to find SARS-CoV-2.
We had a very good collaborator,
Professor Matthew Exline from the Wexner Medical Center,
who had been treating COVID-19 patients from the beginning.
And here you see my team
and you see the three sensors in the breath device,
the COVID-19 breath test,
and in the next slide,
you see the first consideration
was to keep the staff, my staff, the clinical staff, safe.
And for that, instead of just exhaling into the breathalyzer,
we use these breath bags.
Here you see them.
They have been collecting breath
from intubated patients in the intensive care unit.
So that’s how we started the clinical testing.
We take 23 COVID-positive and 23 non-COVID but sick people
in the intensive care unit.
And then we found the signature for COVID-19.
And we did that with an accuracy of 96%, which was impressive.
After we did this, we went down to the swab stations,
and we tested more than 200 other people.
Here, you see how we collected the bag.
And then here on the right,
you see how the bags interface with the breathalyzer,
the small, tiny device, portable handheld device over there.
So what happens is the molecules of the chemicals from my breath
interact with the sensor material
and we get the signature.
And the signature is the breath-print for COVID-19,
which is telling you that someone is positive, is sick.
So we did that.
We were very, very excited.
And here you see the breath-print of COVID-19,
which is like the small Greek letter “omega,”
with two reducing and one oxidizing peak.
And if you look at the middle peak,
it is the intensity of that peak
that tells you the severity of the disease.
We were very, very excited
because we have demonstrated now that we have a novel technology,
novel nanotechnology,
for breath-based detection of COVID-19.
And this happens with a single exhale and within just 15 seconds.
Now, this is revolutionary because it allows us to open schools,
test people in retail stores, in athletic venues,
and allow people to travel
and allow us to resume our normal life.
So, with this technology, we are also able to detect people
that molecular testing seems to be failing.
And there are recent reports show that molecular tests
cannot really get asymptomatics and the ones that are early COVID;
therefore, there is a dire need for rapid testing of this type.
And we have demonstrated this platform technology
that is not only going to revolutionize public health,
it's going also to create a platform
for mitigating future threats by other emerging viruses
in a non-ingressive/intrusive, non-invasive manner and rapidly.
And with this, I believe that you will agree with me
that breath is the new assay for medical diagnostics.
And I want to thank you very, very much.