Correlation of SARS-CoV-2 RNA in wastewater with COVID-19 disease burden in sewersheds

Jennifer Weidhaas,Zachary T Aanderud,D Keith Roper,James Vanderslice,Erica Brown Gaddis,Jeff Ostermiller,Ken Hoffman,Rubayat Jamal,Phillip Heck,Yue Zhang,Kevin Torgersen,Jacob Vander Laan,Nathan Lacross

doi:10.1016/j.scitotenv.2021.145790

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (COVID-19), is shed in feces and the viral ribonucleic acid (RNA) is detectable in wastewater. A nine-week wastewater epidemiology study of ten wastewater facilities, serving 39% of the state of Utah or 1.26 M individuals was conducted in April and May of 2020. COVID-19 cases were tabulated from within each sewershed boundary. RNA from SARS-CoV-2 was detectable in 61% of 126 wastewater samples. Urban sewersheds serving >100,000 individuals and tourist communities had higher detection frequencies. An outbreak of COVID-19 across two communities positively correlated with an increase in wastewater SARS-CoV-2 RNA, while a decline in COVID-19 cases preceded a decline in RNA. SARS-CoV-2 RNA followed a first order decay rate in wastewater, while 90% of the RNA was present in the liquid phase of the influent. Infiltration and inflow, virus decay and sewershed characteristics should be considered during correlation analysis of SAR-CoV-2 with COVID-19 cases. These results provide evidence of the utility of wastewater epidemiology to assist in public health responses to COVID-19.

Highlights

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the coronavirus disease (COVID-19)
During the nine-week study from April 1 to May 28 of 2020, SARS-CoV-2 ribonucleic acids (RNA) was detectable in wastewater influent to ten facilities in 61% of the 126 unique influent samples, not including replicates or sub-sewershed samples
Facilities in more urbanized areas that serve more than 100,000 people had higher detection frequencies (i.e., Central Valley Water Reclamation Facility (CVWRF) 96%, Timpanogos Special Service District (TSSD) 40%, SLCWRF 100%, and Orem WRF (OWRF) 82%) as compared to facilities serving smaller communities (i.e., HCWWTP 56%, TWWP 13%, PRWID 27% and Logan City Corporation WWTP (LCCWWTP) 50%)

Summary

Introduction

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the coronavirus disease (COVID-19). SARS-CoV-2 virions and viral ribonucleic acids (RNA) are detectable by molecular biology based methods in various patient samples including respiratory nasopharyngeal and oropharyngeal swabs 2, serum and tissues [3, 4]. SARS-CoV-2 infects cells in the gastrointestinal tract, glandular epithelial cells 3, and likely is responsible for early reports of 10% of COVID-19 hospital patients with gastrointestinal symptoms such as diarrhea, nausea, abdominal pain, and vomiting 5. These glandular epithelial cells express angiotensin-converting enzyme 2 (ACE2), the cellular receptor for SARS-CoV-2 and SARS-CoV, found in lung and oral mucosa [6, 7]. Concentrations of SARS-CoV-2 in feces of nine patients (15.3%)

Methods

Results

Conclusion