Abstract

The emergence of SARS-CoV-2 variants of concern (VOCs) and variants of interest (VOIs) poses an increased risk to global public health and underlines the need to prioritise monitoring and research to better respond to the COVID-19 pandemic. Wastewater monitoring can be used to monitor SARS-CoV-2 spread and to track SARS-CoV-2 variants. A long read amplicon sequencing approach based on the Oxford Nanopore technology, targeting the spike protein, was applied to detect SARS-CoV-2 variants in sewage samples collected in central Italy on April 2021. Next-generation sequencing was performed on three pooled samples. For variant identification, two approaches–clustering (unsupervised) and classification (supervised)–were implemented, resulting in the detection of two VOCs and one VOI. Key mutations of the Alpha variant (B.1.1.7) were detected in all of the pools, accounting for the vast majority of NGS reads. In two different pools, mutations of the Gamma (P.1) and Eta (B.1.525) variants were also detected, accounting for 22.4%, and 1.3% of total NGS reads of the sample, respectively. Results were in agreement with data on variant circulation in Italy at the time of wastewater sample collection. For each variant, in addition to the signature key spike mutations, other less common mutations were detected, including the amino acid substitutions S98F and E484K in the Alpha cluster (alone and combined), and S151I in the Eta cluster. Results of the present study show that the long-read sequencing nanopore technology can be successfully used to explore SARS-CoV-2 diversity in sewage samples, where multiple variants can be present, and that the approach is sensitive enough to detect variants present at low abundance in wastewater samples. In conclusion, wastewater monitoring can help one discover the spread of variants in a community and early detect the emerging of clinically relevant mutations or variants.

Highlights

  • Coronavirus disease 2019 (COVID-19), the viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the cause of the ongoing worldwide public health emergency

  • Taking into account the likelihood of having an impact on the epidemiological situation in the EU/EEA, slightly different assignations are reported by the European Centre for Disease Control (ECDC) as of 5 August 2021, with Theta and Epsilon variants still on the variants of interest (VOIs) list, and the Iota variant instead included among variants under monitoring

  • Sewage samples (45 mL) were centrifuged at 4500× g for 30 min; after centrifugation 40 mL of sample were mixed with polyethylene glycol 8000 8% and NaCl (0.3 M)

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Summary

Introduction

Coronavirus disease 2019 (COVID-19), the viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the cause of the ongoing worldwide public health emergency. The emergence of variants that posed an increased risk to global public health prompted the characterisation of specific variants of concern (VOCs) and variants of interest (VOIs) in order to prioritise global monitoring and research, and to inform the ongoing response to the COVID-19 pandemic (tracking SARS-CoV-2 variants (who.int)). VOIs have mutations with established or suspected phenotypic implications that could imply an effect on transmissibility, severity and/or immunity, realistically having an impact on the epidemiological situation (SARS-CoV-2 variants of concern as of 18 June 2021 (https://www.ecdc.europa.eu/en/covid-19/variants-concern, accessed on 11 August 2021). Taking into account the likelihood of having an impact on the epidemiological situation in the EU/EEA, slightly different assignations are reported by the European Centre for Disease Control (ECDC) as of 5 August 2021, with Theta and Epsilon variants still on the VOI list, and the Iota variant instead included among variants under monitoring (https://www.ecdc.europa.eu/en/covid-19/variants-concern, accessed on 11 August 2021)

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