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Understanding the dynamic relation between wastewater SARS-CoV-2 signal and clinical metrics throughout the pandemic
Preprint
in English
| medRxiv
| ID: ppmedrxiv-22277318
ABSTRACT
Wastewater surveillance (WWS) of SARS-CoV-2 was proven to be a reliable and complementary tool for population-wide monitoring of COVID-19 disease incidence but was not as rigorously explored as an indicator for disease burden throughout the pandemic. Prior to global mass immunization campaigns and during the spread of the wildtype COVID-19 and the Alpha variant of concern (VOC), viral measurement of SARS-CoV-2 in wastewater was a leading indicator for both COVID-19 incidence and disease burden in communities. As the two-dose vaccination rates escalated during the spread of the Delta VOC in Jul. 2021 through Dec. 2021, relations weakened between wastewater signal and community COVID-19 disease incidence and maintained a strong relationship with clinical metrics indicative of disease burden (new hospital admissions, ICU admissions, and deaths). Further, with the onset of the vaccine-resistant Omicron BA.1 VOC in Dec. 2021 through Mar. 2022, wastewater again became a strong indicator of both disease incidence and burden during a period of limited natural immunization (no recent infection), vaccine escape, and waned vaccine effectiveness. Lastly, with the populations regaining enhanced natural and vaccination immunization shortly prior to the onset of the Omicron BA.2 VOC in mid-Mar 2022, wastewater is shown to be a strong indicator for both disease incidence and burden. Hospitalization-to-wastewater ratio is further shown to be a good indicator of VOC virulence when widespread clinical testing is limited. In the future, WWS is expected to show moderate indication of incidence and strong indication of disease burden in the community during future potential seasonal vaccination campaigns. HighlightsO_LINeed to elucidate interpretation of CoV-2 WWS for seasonal vaccination campaigns. C_LIO_LIWWS to incidence relation weakens with peak natural and vaccination immunization. C_LIO_LIWWS to hospitalization remains strong with natural and vaccination immunization. C_LIO_LIWWS as indicator of hospitalization during future seasonal vaccination campaigns. C_LIO_LIWWS/hospitalization as indicator of VOC virulence with limited clinical testing. C_LI
cc_by_nc_nd
Full text:
Available
Collection:
Preprints
Database:
medRxiv
Type of study:
Observational study
/
Prognostic study
Language:
English
Year:
2022
Document type:
Preprint