ArticleThe Science of the total environment2023
Predictive potential of SARS-CoV-2 RNA concentration in wastewater to assess the dynamics of COVID-19 clinical outcomes and infections.
Article in The Science of the total environment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Influence of Sampling Strategies and Disease Prevalence on SARS-CoV-2 Detection Dynamics in Wastewater Surveillance.Viruses · 2026Article
- Diagnostic Value and Outcomes of Systematic SARS-CoV-2 Screening in Asymptomatic Patients.JAMA network open · 2026Article
- Seasonal Variations in the Occurrence of SARS-CoV-2 RNA Recovered from Wastewater Treatment Facilities (WWTFs) Within South Africa.Microorganisms · 2026Article
- A One-Year Wastewater-Based Surveillance Study of the Main Human Respiratory Viruses in a Middle-Size Spanish City During the COVID-19 Pandemic Period.Microorganisms · 2026Article
- SARS-CoV-2 wastewater surveillance in a central Chinese metropolis: variant responses and correlation with clinical cases.Frontiers in public health · 2026Article
- Long-term wastewater surveillance of SARS-CoV-2: a 5.5-year study reveals correlation with public health indicators and early warning potential during and after the pandemic.Frontiers in microbiology · 2026Article
- The potential of long-term wastewater-based surveillance to predict COVID-19 waves peak in Mexico.Water environment research : a research publication of the Water Environment Federation · 2025Article
- Temporal dynamics of SARS-CoV-2 detection in wastewater and population infection trends in Mexico City.Frontiers in public health · 2025Article
- Multisite community-scale monitoring of respiratory and enteric viruses in the effluent of a nursing home and in the inlet of the local wastewater treatment plant.Applied and environmental microbiology · 2024Article
- Article
- SARS-CoV-2 wastewater surveillance in the Czech Republic: Spatial and temporal differences in SARS-CoV-2 RNA concentrations and relationship to clinical data and wastewater parameters.Water research X · 2024Article
- Wastewater surveillance provides 10-days forecasting of COVID-19 hospitalizations superior to cases and test positivity: A prediction study.Infectious Disease Modelling · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Coronavirus disease 2019 - caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -, has triggered a worldwide pandemic resulting in 665 million infections and over 6.5 million deaths as of December 15, 2022. The development of different epidemiological tools have helped predict new outbreaks and assess the behavior of clinical variables in different health contexts. In this study, we aimed to monitor concentrations of SARS-CoV-2 in wastewater as a tool to predict the progression of clinical variables during Waves 3, 5, and 6 of the pandemic in the Spanish city of Xátiva from September 2020 to March 2022. We estimated SARS-CoV-2 RNA concentrations in 195 wastewater samples using the RT-PCR Diagnostic Panel validated by the Center for Disease Control and Prevention. We also compared the trends of several clinical variables (14-day cumulative incidence, positive cases, hospital cases and stays, critical cases and stays, primary care visits, and deaths) for each study wave against wastewater SARS-CoV-2 RNA concentrations using Pearson's product-moment correlations, a two-sided Mann-Whitney U test, and a cross-correlation analysis. We found strong correlations between SARS-CoV-2 concentrations with 14-day cumulative incidence and positive cases over time. Wastewater RNA concentrations showed strong correlations with these variables one and two weeks in advance. There were significant correlations with hospitalizations and critical care during Wave 3 and Wave 6; cross-correlations were stronger for hospitalization stays one week before during Wave 6. No association between vaccination percentages and wastewater viral concentrations was observed. Our findings support wastewater SARS-CoV-2 concentrations as a potential surveillance tool to anticipate infection and epidemiological data such as 14-day cumulative incidence, hospitalizations, and critical care stays. Public health authorities could use this epidemiological tool on a similar population as an aid for health care decision-making during an epidemic outbreak.
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