ArticlePeerJ2026
Nationwide wastewater sequencing surveillance of SARS-CoV-2 lineages: validation against clinical data across 28 U.S. states.
Article in PeerJ, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Prospective metagenomic sequencing of wastewater across the United States yields robust viral enrichment and concordance with digital PCR measurements.Applied and environmental microbiology · 2026Article
- Long-Term Wastewater Genomic Surveillance Reveals SARS-CoV-2 Variant Dynamics in Italy from 2021 to 2025.Food and environmental virology · 2026Article
- Early Detection and Surveillance of the SARS-CoV-2 Variant BA.3.2 - Worldwide, November 2024-February 2026.MMWR. Morbidity and mortality weekly report · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
As clinical SARS-CoV-2 surveillance programs are being reduced, wastewater-based epidemiology (WBE) has emerged as a promising alternative for monitoring viral circulation. However, large-scale validation of wastewater sequencing against clinical data across multiple lineages and geographic regions remains limited. This study aimed to evaluate the concordance between wastewater and clinical SARS-CoV-2 lineage surveillance at a national scale and assess patterns of lineage emergence and geographic spread. From September 11, 2023, to April 1, 2025, we collected 3,151 wastewater samples from 42 treatment plants across 28 U.S. states. Samples underwent tiled amplicon sequencing using ARTIC V5.3.2 primers, with lineage abundance estimated using Freyja. We compared wastewater lineage proportions to CDC clinical surveillance data using Spearman rank correlation coefficients and analyzed temporal patterns of lineage emergence and geographic distribution. Wastewater lineage abundances showed strong positive correlations with clinical data across all major Pango lineages, with Spearman coefficients ranging from 0.46 (Omicron BA) to 0.94 (Omicron XEC), all statistically significant (
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