Abstract
The etiological agent for novel coronavirus (COVID-19, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), not only affects the human respiratory system, but also the gastrointestinal tract resulting in gastrointestinal manifestations. The high rate of asymptomatic infected individuals has challenged the estimation of infection spread based on patients’ surveillance, and thus alternative approaches such as wastewater-based epidemiology (WBE) have been proposed. Accordingly, the number of publications on this topic has increased substantially. The present systematic review thus aimed at providing state-of-the-knowledge on the occurrence and existing methods for sampling procedures, detection/quantification of SARS-CoV-2 in sewage samples, as well as anticipating challenges and providing future research direction to improve the current scientific knowledge. Articles were collected from three scientific databases. Only studies reporting measurements of virus in stool, urine, and wastewater samples were included. Results showed that improving the scientific community’s understanding in these avenues is essential if we are to develop appropriate policy and management tools to address this pandemic pointing particularly towards WBE as a new paradigm in public health. It was also evident that standardized protocols are needed to ensure reproducibility and comparability of outcomes. Areas that require the most improvements are sampling procedures, concentration/enrichment, detection, and quantification of virus in wastewater, as well as positive controls. Results also showed that selecting the most accurate population estimation method for WBE studies is still a challenge. While the number of people infected in an area could be approximately estimated based on quantities of virus found in wastewater, these estimates should be cross-checked by other sources of information to draw a more comprehensive conclusion. Finally, wastewater surveillance can be useful as an early warning tool, a management tool, and/or a way for investigating vaccination efficacy and spread of new variants.
Highlights
During the years 2003–2004, the outbreak of severe acute respiratory syndrome coronavirus (SARS-CoV) afflicted people throughout the world and was poised to be the pandemic
Detection and quantification of SARS-CoV-2 in wastewater coupled with their accompanied challenges, potential risks, and application of results have been outlined in the third, Section 3.3
In the context of these studies, Ahmed et al [15] tried to translate this value to a log-uniform distribution from 2.56 to 7.67 as noticed during the periods of heaviest shedding among mild cases of COVID-19. These results provide further support to estimate the number of infected cases within the community via wastewater-based epidemiology, as a new paradigm in public-health assessment
Summary
During the years 2003–2004, the outbreak of severe acute respiratory syndrome coronavirus (SARS-CoV) afflicted people throughout the world and was poised to be the pandemic. The virus, was responsible for just over 8400 cases with fewer than 1000 deaths in 29 countries and studies concerning infection-control measures were instrumental in severely curtailing the potential for a pandemic [1,2]. The “novel coronavirus-infected pneumonia” was officially designated as SARS-CoV-2 after being provisionally named as 2019-nCoV [3,4]. On 31 January 2020, the World Health Organization (WHO) declared the outbreak to constitute a public-health emergency of international concern when the disease was reported in 114 countries and thence named this disease as Corona Virus Disease 2019 (COVID-19) on 11 February 2020 [5,6]. By 2 July 2021, 182,653,642 confirmed cases, including 3,955,835 deaths, was officially announced all over the world, with distressing consequences on human health and economy, in the United States, India, Brazil, and Russia, among others [7]
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