Noninvasive and Point-of-Care Surface-Enhanced Raman Scattering (SERS)-Based Breathalyzer for Mass Screening of Coronavirus Disease 2019 (COVID-19) under 5 min

Population-wide surveillance of COVID-19 requires tests to be quick and accurate to minimize community transmissions. The detection of breath volatile organic compounds presents a promising option for COVID-19 surveillance but is currently limited by bulky instrumentation and inflexible analysis protocol. Here, we design a hand-held surface-enhanced Raman scattering-based breathalyzer to identify COVID-19 infected individuals in under 5 min, achieving >95% sensitivity and specificity across 501 participants regardless of their displayed symptoms. Our SERS-based breathalyzer harnesses key variations in vibrational fingerprints arising from interactions between breath metabolites and multiple molecular receptors to establish a robust partial least-squares discriminant analysis model for high throughput classifications. Crucially, spectral regions influencing classification show strong corroboration with reported potential COVID-19 breath biomarkers, both through experiment and in silico. Our strategy strives to spur the development of next-generation, noninvasive human breath diagnostic toolkits tailored for mass screening purposes. Agency for Science, Technology and Research (A*STAR) Nanyang Technological University National Medical Research Council (NMRC) Submitted/Accepted version This research is supported by National Medical Research Council, Singapore under COVID-19 Research Fund (MOH-COVID19RF-0007 and MOH-COVID19RF-0012), A*STAR Singapore, AME Individual Research Grant (A20E5c0082) and Max Planck Institute-Nanyang Technological University Joint Lab. S.X.L and L.B.T.N. acknowledge Nanyang Presidential scholarship support from Nanyang Technological University, Singapore.