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  • A wastewater-based epidemio...
    Monteiro, Sílvia; Rente, Daniela; Cunha, Mónica V.; Gomes, Manuel Carmo; Marques, Tiago A.; Lourenço, Artur B.; Cardoso, Eugénia; Álvaro, Pedro; Silva, Marco; Coelho, Norberta; Vilaça, João; Meireles, Fátima; Brôco, Nuno; Carvalho, Marta; Santos, Ricardo

    The Science of the total environment, 01/2022, Letnik: 804
    Journal Article

    The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in wastewater produced interest in its use for sentinel surveillance at a community level and as a complementary approach to syndromic surveillance. With this work, we set the foundations for wastewater-based epidemiology (WBE) in Portugal by monitoring the trends of SARS-CoV-2 RNA circulation in the community, on a nationwide perspective during different epidemiological phases of the pandemic. The Charité assays (E_Sarbecco, RdRP, and N_Sarbecco) were applied to monitor, over 32-weeks (April to December 2020), the dynamics of SARS-CoV-2 RNA at the inlet of five wastewater treatment plants (WWTP), which together serve more than two million people in Portugal. Raw wastewater from three Coronavirus disease 2019 (COVID-19) reference hospitals was also analyzed during this period. In total, more than 600 samples were tested. For the first weeks, detection of SARS-CoV-2 RNA was sporadic, with concentrations varying from 103 to 105 genome copies per liter (GC/L). Prevalence of SARS-CoV-2 RNA increased steeply by the end of May into late June, mainly in Lisboa e Vale do Tejo region (LVT), during the reopening phase. After the summer, with the reopening of schools in mid-September and return to partial face-to-face work, a pronounced increase of SARS-CoV-2 RNA in wastewater was detected. In the LVT area, SARS-CoV-2 RNA load agreed with reported trends in hotspots of infection. Synchrony between trends of SARS-CoV-2 RNA in raw wastewater and daily new COVID-19 cases highlights the value of WBE as a surveillance tool, particularly after the phasing out of the epidemiological curve and when hotspots of disease re-emerge in the population which might be difficult to spot based solely on syndromic surveillance and contact tracing. This is the first study crossing several epidemiological stages highlighting the long-term use of WBE for SARS-CoV-2. Display omitted •SARS-CoV-2 monitored over 32-weeks encompassing different epidemiological stages.•Five wastewater treatment plants, representing over two million people, were tested.•Trends of SARS-CoV-2 in wastewater followed trends of daily new cases in Portugal.•Sampling strategy may have a marked impact in the detection of SARS-CoV-2.•Long-term potential of WBE as a complementary tool to clinical surveillance demonstrated.