Prolonged severe acute respiratory coronavirus virus 2 (SARS-CoV-2) viral shedding in lower-respiratory specimens of critically ill patients does not correlate with nasopharyngeal swab results

Brailita, Daniel M; Cushman‐Vokoun, Allison M.; Wood, Macy G.; Crowley, Ann M.; Rapp, Sharleen A.; Fey, Paul D.; Rupp, Mark E.; Hewlett, Angela

doi:10.1017/ice.2022.139

Cited by 1 publication

(2 citation statements)

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“…Furthermore, protracted Delta virus shedding may reduce associations using our 14‐day definition of active‐disease 37 . Finally, there is strong evidence that prolonged shedding occurs in those who are heavily immunosuppressed 38 and in those with critical illness 39 which were more common during Delta. Further studies that focus on specific hospital wards may shed more light on target sub‐populations.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, protracted Delta virus shedding may reduce associations using our 14-day definition of active-disease. 37 Finally, there is strong evidence that prolonged shedding occurs in those who are heavily immunosuppressed 38 and in those with critical illness 39 which While monitoring at wastewater treatment plants is a sustainable approach to monitoring COVID-19 and the emergence of novel variants in communities, it is also important to monitor at a more granular scale (e.g., hospitals) since it can support the targeted protection of a population. 30 For example, the Omicron wave in Alberta created a case burden that surpassed the capacity of the health care system to diagnose individual cases using RT-qPCR assays-resulting in inaccurate case attainment data.…”

Section: Discussionmentioning

confidence: 99%

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Surveillance for SARS‐CoV‐2 and its variants in wastewater of tertiary care hospitals correlates with increasing case burden and outbreaks

Acosta

Bautista

Waddell

et al. 2023

Journal of Medical Virology

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Wastewater-based SARS-CoV-2 surveillance enables unbiased and comprehensive monitoring of defined sewersheds. We performed real-time monitoring of hospital wastewater that differentiated Delta and Omicron variants within total SARS-CoV-2-RNA, enabling correlation to COVID-19 cases from three tertiary-care facilities with >2100 inpatient beds in Calgary, Canada. RNA was extracted from hospital wastewater between August/2021 and January/2022, and SARS-CoV-2 quantified using RT-qPCR.Assays targeting R203M and R203K/G204R established the proportional abundance of Delta and Omicron, respectively. Total and variant-specific SARS-CoV-2 in wastewater was compared to data for variant specific COVID-19 hospitalizations, hospital-acquired infections, and outbreaks. Ninety-six percent (188/196) of wastewater samples were SARS-CoV-2 positive. Total SARS-CoV-2 RNA levels in wastewater increased in tandem with total prevalent cases (Delta plus Omicron). Variant-specific assessments showed this increase to be mainly driven by Omicron. Hospital-acquired cases of COVID-19 were associated with large spikes in wastewater SARS-CoV-2 and levels were significantly increased during outbreaks relative to nonoutbreak periods for total SARS-CoV2, Delta and Omicron. SARS-CoV-2 in hospital wastewater was significantly higher during the Omicron-wave irrespective of outbreaks. Wastewater-based monitoring of SARS-CoV-2 and its variants represents a novel tool for passive COVID-19 infection surveillance, case identification, containment, and potentially to mitigate viral spread in hospitals.

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Section: Discussionmentioning

confidence: 99%