Faculty of Health Sciences, Valencian International University (VIU), 46002, Valencia, Spain; Global Omnium, Valencia, Spain.
Global Omnium, Valencia, Spain.
Sci Total Environ. 2023 Aug 15;886:163935. doi: 10.1016/j.scitotenv.2023.163935. Epub 2023 May 8.
Coronavirus disease 2019 - caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -, has triggered a worldwide pandemic resulting in 665 million infections and over 6.5 million deaths as of December 15, 2022. The development of different epidemiological tools have helped predict new outbreaks and assess the behavior of clinical variables in different health contexts. In this study, we aimed to monitor concentrations of SARS-CoV-2 in wastewater as a tool to predict the progression of clinical variables during Waves 3, 5, and 6 of the pandemic in the Spanish city of Xátiva from September 2020 to March 2022. We estimated SARS-CoV-2 RNA concentrations in 195 wastewater samples using the RT-PCR Diagnostic Panel validated by the Center for Disease Control and Prevention. We also compared the trends of several clinical variables (14-day cumulative incidence, positive cases, hospital cases and stays, critical cases and stays, primary care visits, and deaths) for each study wave against wastewater SARS-CoV-2 RNA concentrations using Pearson's product-moment correlations, a two-sided Mann-Whitney U test, and a cross-correlation analysis. We found strong correlations between SARS-CoV-2 concentrations with 14-day cumulative incidence and positive cases over time. Wastewater RNA concentrations showed strong correlations with these variables one and two weeks in advance. There were significant correlations with hospitalizations and critical care during Wave 3 and Wave 6; cross-correlations were stronger for hospitalization stays one week before during Wave 6. No association between vaccination percentages and wastewater viral concentrations was observed. Our findings support wastewater SARS-CoV-2 concentrations as a potential surveillance tool to anticipate infection and epidemiological data such as 14-day cumulative incidence, hospitalizations, and critical care stays. Public health authorities could use this epidemiological tool on a similar population as an aid for health care decision-making during an epidemic outbreak.
2019 年冠状病毒病 - 由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起 - 引发了全球大流行，截至 2022 年 12 月 15 日，已导致 6.65 亿感染和超过 650 万人死亡。不同的流行病学工具的发展有助于预测新的疫情爆发，并评估不同卫生环境下临床变量的行为。在这项研究中，我们旨在监测废水样本中 SARS-CoV-2 的浓度，作为预测西班牙哈蒂瓦市疫情第 3、5 和 6 波期间临床变量进展的工具，监测时间为 2020 年 9 月至 2022 年 3 月。我们使用美国疾病控制与预防中心验证的 RT-PCR 诊断试剂盒，对 195 个废水样本进行了 SARS-CoV-2 RNA 浓度的估计。我们还使用 Pearson 积矩相关、双侧 Mann-Whitney U 检验和交叉相关分析，比较了各研究波次与废水 SARS-CoV-2 RNA 浓度相关的几个临床变量（14 天累计发病率、阳性病例、住院病例和住院时间、重症病例和住院时间、初级保健就诊和死亡）的趋势。我们发现，随着时间的推移，SARS-CoV-2 浓度与 14 天累计发病率和阳性病例之间存在很强的相关性。废水 RNA 浓度与这些变量提前一到两周有很强的相关性。在第 3 波和第 6 波期间与住院和重症监护存在显著相关性；在第 6 波期间，住院时间的交叉相关性更强。废水病毒浓度与疫苗接种比例之间没有关联。我们的研究结果支持将 SARS-CoV-2 浓度作为一种潜在的监测工具，以预测感染和 14 天累计发病率、住院和重症监护等流行病学数据。公共卫生当局可以在类似人群中使用这种流行病学工具，作为疫情爆发期间医疗决策的辅助手段。
