@article{83190c33fad44e208e0552b08ff317c9,
title = "Surveillance for SARS-CoV-2 and its variants in wastewater of tertiary care hospitals correlates with increasing case burden and outbreaks",
abstract = "Wastewater-based SARS-CoV-2 surveillance enables unbiased and comprehensive monitoring of defined sewersheds. We performed real-time monitoring of hospital wastewater that differentiated Delta and Omicron variants within total SARS-CoV-2-RNA, enabling correlation to COVID-19 cases from three tertiary-care facilities with >2100 inpatient beds in Calgary, Canada. RNA was extracted from hospital wastewater between August/2021 and January/2022, and SARS-CoV-2 quantified using RT-qPCR. Assays targeting R203M and R203K/G204R established the proportional abundance of Delta and Omicron, respectively. Total and variant-specific SARS-CoV-2 in wastewater was compared to data for variant specific COVID-19 hospitalizations, hospital-acquired infections, and outbreaks. Ninety-six percent (188/196) of wastewater samples were SARS-CoV-2 positive. Total SARS-CoV-2 RNA levels in wastewater increased in tandem with total prevalent cases (Delta plus Omicron). Variant-specific assessments showed this increase to be mainly driven by Omicron. Hospital-acquired cases of COVID-19 were associated with large spikes in wastewater SARS-CoV-2 and levels were significantly increased during outbreaks relative to nonoutbreak periods for total SARS-CoV2, Delta and Omicron. SARS-CoV-2 in hospital wastewater was significantly higher during the Omicron-wave irrespective of outbreaks. Wastewater-based monitoring of SARS-CoV-2 and its variants represents a novel tool for passive COVID-19 infection surveillance, case identification, containment, and potentially to mitigate viral spread in hospitals.",
keywords = "COVID-19, RT-qPCR, hospital-acquired infection, prevalent, variant of concern, wastewater-based surveillance",
author = "Nicole Acosta and Bautista, {Maria A.} and Waddell, {Barbara J.} and Kristine Du and Janine McCalder and Puja Pradhan and Navid Sedaghat and Chloe Papparis and Beaudet, {Alexander Buchner} and Jianwei Chen and {Van Doorn}, Jennifer and Kevin Xiang and Leslie Chan and Laura Vivas and Kashtin Low and Xuewen Lu and Jangwoo Lee and Paul Westlund and Thierry Chekouo and Xiaotian Dai and Jason Cabaj and Srijak Bhatnagar and Norma Ruecker and Gopal Achari and Clark, {Rhonda G.} and Craig Pearce and Harrison, {Joe J.} and Jon Meddings and Jenine Leal and Jennifer Ellison and Bayan Missaghi and Kanji, {Jamil N.} and Oscar Larios and Elissa Rennert-May and Joseph Kim and Hrudey, {Steve E.} and Lee, {Bonita E.} and Xiaoli Pang and Kevin Frankowski and John Conly and Hubert, {Casey R.J.} and Parkins, {Michael D.}",
note = "Funding Information: The investigators are grateful to all staff of City of Calgary for their support on provision of samples. The authors also are appreciative of the staff at Alberta Health Services Infection Prevention and Control, and DIMR (Analytics, Data Integration, Measurement & Reporting) for data collection and sharing. We thank Drs Meghan Fuzzen, Nathanael B.J. Harper and Mark Servos from the University of Waterloo, Waterloo, Ontario, Canada for sharing the N200 assay protocol. This work was supported by grants from the Canadian Institute of Health Research [448242 to M.D.P.]; and from Alberta Health [M.D.P., K.F., C.R.J.H., X.P., B.L. and S.E.H.]. Funding Information: The investigators are grateful to all staff of City of Calgary for their support on provision of samples. The authors also are appreciative of the staff at Alberta Health Services Infection Prevention and Control, and DIMR (Analytics, Data Integration, Measurement & Reporting) for data collection and sharing. We thank Drs Meghan Fuzzen, Nathanael B.J. Harper and Mark Servos from the University of Waterloo, Waterloo, Ontario, Canada for sharing the N200 assay protocol. This work was supported by grants from the Canadian Institute of Health Research [448242 to M.D.P.]; and from Alberta Health [M.D.P., K.F., C.R.J.H., X.P., B.L. and S.E.H.]. Publisher Copyright: {\textcopyright} 2022 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.",
year = "2023",
month = feb,
doi = "10.1002/jmv.28442",
language = "English",
volume = "95",
number = "2",
}
