The amount of SARS-CoV-2 RNA in wastewater relates to the development of the pandemic and its burden on the health system

Hao Wang; Marianela Patzi Churqui; Timur Tunovic; Lucica Enache; Anette Johansson; Ambjörn Kärmander; Staffan Nilsson; Martin Lagging; Maria Andersson; Leif Dotevall; Thomas Brezicka; Kristina Nyström; Heléne Norder

doi:10.1016/j.isci.2022.105000

The amount of SARS-CoV-2 RNA in wastewater relates to the development of the pandemic and its burden on the health system

iScience. 2022 Sep 16;25(9):105000. doi: 10.1016/j.isci.2022.105000. Epub 2022 Aug 24.

Authors

Hao Wang^{1

2}, Marianela Patzi Churqui¹, Timur Tunovic¹, Lucica Enache³, Anette Johansson³, Ambjörn Kärmander¹, Staffan Nilsson⁴, Martin Lagging^{1

2}, Maria Andersson^{1

2}, Leif Dotevall⁵, Thomas Brezicka⁶, Kristina Nyström^{1

2}, Heléne Norder^{1

2}

Affiliations

¹ Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden.
² Sahlgrenska University Hospital, Department of Clinical Microbiology, Region Västra Götaland, Gothenburg, Sweden.
³ Gryaab AB, Gothenburg 402 74, Sweden.
⁴ Institute of Biomedicine, Department of Pathology and Genetics, University of Gothenburg, Gothenburg, Sweden.
⁵ Department of Communicable Disease Control, Region Västra Götaland, Gothenburg, Sweden.
⁶ Sahlgrenska University Hospital, Department of Quality and Patient Safety, Region Västra Götaland, Gothenburg, Sweden.

Abstract

Virus surveillance in wastewater can be a useful indicator of the development of the COVID-19 pandemic in communities. However, knowledge about how the amount of SARS-CoV-2 RNA in wastewater relates to different data on the burden on the health system is still limited. Herein, we monitored the amount of SARS-CoV-2 RNA and the spectrum of virus variants in weekly pooled wastewater samples for two years from mid-February 2020 and compared them with several clinical data. The two-year monitoring showed the weekly changes in the amount of viral RNA in wastewater preceded the hospital care needs for COVID-19 and the number of acute calls on adult acute respiratory distress by 1-2 weeks during the first three waves of COVID-19. Our study demonstrates that virus surveillance in wastewater can predict the development of a pandemic and its burden on the health system, regardless of society's test capacity and possibility of tracking infected cases.

Keywords: Environmental medicine; Public health; Virology.