Honoria Ocagli, Marco Zambito, Filippo Da Re, Vanessa Groppi, Marco Zampini, Alessia Terrini, Franco Rigoli, Irene Amoruso, Tatjana Baldovin, Vincenzo Baldo, Francesca Russo, Dario Gregori
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引用次数: 0
Abstract
Background: As the COVID-19 pandemic has affected populations around the world, there has been substantial interest in wastewater-based epidemiology (WBE) as a tool to monitor the spread of SARS-CoV-2. This study investigates the use of WBE to anticipate COVID-19 trends by analyzing the correlation between viral RNA concentrations in wastewater and reported COVID-19 cases in the Veneto region of Italy.
Objective: We aimed to evaluate the effectiveness of the cumulative sum (CUSUM) control chart method in detecting changes in SARS-CoV-2 concentrations in wastewater and its potential as an early warning system for COVID-19 outbreaks. Additionally, we aimed to validate these findings over different time periods to ensure robustness.
Methods: This study analyzed the temporal correlation between SARS-CoV-2 RNA concentrations in wastewater and COVID-19 clinical outcomes, including confirmed cases, hospitalizations, and intensive care unit (ICU) admissions, from October 2021 to August 2022 in the Veneto region, Italy. Wastewater samples were collected weekly from 10 wastewater treatment plants and analyzed using a reverse transcription-quantitative polymerase chain reaction. The CUSUM method was used to detect significant shifts in the data, with an initial analysis conducted from October 2021 to February 2022, followed by validation in a second period from February 2022 to August 2022.
Results: The study found that peaks in SARS-CoV-2 RNA concentrations in wastewater consistently preceded peaks in reported COVID-19 cases by 5.2 days. Hospitalizations followed with a delay of 4.25 days, while ICU admissions exhibited a lead time of approximately 6 days. Notably, certain health care districts exhibited stronger correlations, with notable values in wastewater anticipating ICU admissions by an average of 13.5 and 9.5 days in 2 specific districts. The CUSUM charts effectively identified early changes in viral load, indicating potential outbreaks before clinical cases increased. Validation during the second period confirmed the consistency of these findings, reinforcing the robustness of the CUSUM method in this context.
Conclusions: WBE, combined with the CUSUM method, offers valuable insight into the level of COVID-19 outbreaks in a community, including asymptomatic cases, thus acting as a precious early warning tool for infectious disease outbreaks with pandemic potential.
期刊介绍：
JMIR Public Health & Surveillance (JPHS) is a renowned scholarly journal indexed on PubMed. It follows a rigorous peer-review process and covers a wide range of disciplines. The journal distinguishes itself by its unique focus on the intersection of technology and innovation in the field of public health. JPHS delves into diverse topics such as public health informatics, surveillance systems, rapid reports, participatory epidemiology, infodemiology, infoveillance, digital disease detection, digital epidemiology, electronic public health interventions, mass media and social media campaigns, health communication, and emerging population health analysis systems and tools.
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