Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study
Abstract BackgroundAs 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...
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JMIR Publications
2025-01-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2025/1/e58862 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Honoria Ocagli |
| collection | DOAJ |
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Abstract
BackgroundAs 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.
ObjectiveWe 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.
MethodsThis 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.
ResultsThe 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.
ConclusionsWBE, 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. |
| format | Article |
| id | doaj-art-7f1ed76e936a4090b40bed03ba2837b9 |
| institution | Kabale University |
| issn | 2369-2960 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj-art-7f1ed76e936a4090b40bed03ba2837b92025-01-21T21:15:53ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602025-01-0111e58862e5886210.2196/58862Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational StudyHonoria Ocaglihttp://orcid.org/0000-0002-5823-1659Marco Zambitohttp://orcid.org/0009-0003-5279-9694Filippo Da Rehttp://orcid.org/0009-0006-7366-0108Vanessa Groppihttp://orcid.org/0009-0005-2386-018XMarco Zampinihttp://orcid.org/0009-0009-3485-3945Alessia Terrinihttp://orcid.org/0009-0000-1699-6680Franco Rigolihttp://orcid.org/0009-0004-9574-3452Irene Amorusohttp://orcid.org/0000-0003-4954-5848Tatjana Baldovinhttp://orcid.org/0000-0002-7375-9187Vincenzo Baldohttp://orcid.org/0000-0001-6012-9453Francesca Russohttp://orcid.org/0009-0007-9557-7361Dario Gregorihttp://orcid.org/0000-0001-7906-0580 Abstract BackgroundAs 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. ObjectiveWe 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. MethodsThis 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. ResultsThe 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. ConclusionsWBE, 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.https://publichealth.jmir.org/2025/1/e58862 |
| spellingShingle | 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 Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study JMIR Public Health and Surveillance |
| title | Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study |
| title_full | Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study |
| title_fullStr | Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study |
| title_full_unstemmed | Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study |
| title_short | Wastewater Monitoring During the COVID-19 Pandemic in the Veneto Region, Italy: Longitudinal Observational Study |
| title_sort | wastewater monitoring during the covid 19 pandemic in the veneto region italy longitudinal observational study |
| url | https://publichealth.jmir.org/2025/1/e58862 |
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