SARS-CoV-2 Detection and Persistence in a Remote Amazonian Settlement.

Background: COVID-19 continues to pose a major global health challenge. Despite its geographic distance from Brazil's major urban centers, Acre state has experienced notable outbreaks. This study assessed the detection and persistence of SARS-CoV-2 in the rural settlement of Santa Luzia, located in the remote municipality of Cruzeiro do Sul, Acre state, Brazil. Methods: In July 2022, a cross-sectional survey was conducted at 40 sites from an ongoing environmental study, selected by deforestation patterns and proximity to health posts. Saliva samples were collected from residents aged 5-90 years, followed by nucleic acid extraction and multiplex RT-qPCR for SARS-CoV-2 detection. Results: Among the 183 individuals from 40 participating families, an 8% positivity rate was observed, with variation by age and sex. In 30% of families, at least one member tested positive, indicating continued viral presence within the community. Spatial analysis using Global and Local Moran's I statistics showed a random distribution of positive samples, consistent with multiple introductions from nearby urban centers and intermittent local persistence. Conclusion: These findings highlight the ongoing detection and persistence of SARS-CoV-2 in a remote Amazonian community, underscoring the need for continued surveillance in geographically isolated populations.