key: cord-0718815-q9q2hakp authors: Collivignarelli, M. C.; Collivignarelli, C.; Carnevale Miino, M.; Abbampagrave, A.; Pedrazzani, R.; Bertanza, G. title: SARS-CoV-2 in wastewater treatment plants date: 2020-06-08 journal: nan DOI: 10.1101/2020.06.04.20122218 sha: 986a8cff18ca82422afc16601a51bbd67d8734f0 doc_id: 718815 cord_uid: q9q2hakp As for the SARS coronavirus in the 2003 epidemic, the presence of SARS-CoV-2 has been demonstrated in faeces and, in some cases, urine of infected people, as well as in wastewater. This paper proposes a critical review of the state of the art regarding studies on the presence of SARS-CoV-2 in wastewater and sewage sludge, the factors affecting its inactivation and the main proposed treatments, with the aim to provide useful information at operative level in order to better and safer manage wastewater and sewage sludge. Given the lack of literature on SARS-CoV-2, studies involving other HCoVs such as SARS-CoV and HCoV-229E have been also considered. In wastewater, the resistance of SARS-CoV has proven to be very limited, especially at temperatures above 20 {degrees}C, and the virus has been easily removed with the use of chlorine (> 0.5 mg L-1 for 30 min). For sewage sludge, based on in vitro experiments, it is suggested to increase the retention times before a possible reuse in agriculture only for precautionary purposes, since SARS-CoV-2 is unlikely to occur in the sludge. SARS-CoV-2 in wastewater might track the epidemic trends: although being extremely promising, an effective and wide application of this approach requires a deeper knowledge of the amounts of viruses excreted through the faeces and the actual detectability of viral RNA in sewage. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint worldwide thanks to the high rate of infectivity (Remuzzi and Remuzzi, 2020) and the presence of a huge number of 80 asymptomatic or minimally symptomatic patients, hardly identifiable (Zou et al., 2020) . In March 2020, the World 81 Health Organization declared a pandemic state (WHO, 2020a) and, despite in many countries total lockdown was 82 imposed (Collivignarelli et al., 2020; Lau et al., 2020) , CoViD-19 spread in more than 240 countries (25 th May, 2020), 83 millions of people got infected and hundreds of thousands died (WHO, 2020b). The transmission of SARS-CoV-2 person-to-person has been found to be due to its presence in the respiratory tract of 85 infected people (Ghinai et al., 2020) . SARS-CoV-2, however, has been also found in the faeces and urine of infected In order to carry out the review according to the objectives described above, a multi-step methodology has been adopted 104 as reported by other authors (Collivignarelli et database has been used to search relevant literature research papers, reviews, books and conference proceedings. The 106 keywords are "coronavirus", "coronavirus AND faeces", "coronavirus AND urine", and "coronavirus AND 107 wastewater". The analysis has been carried out searching the keywords in the fields "Article title, Abstract, Keywords". 108 All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint These papers have been checked in order to eliminate duplicates and out-of-scope documents. These data were also 109 used to provide a chronological and spatial bibliometric analysis. In recent years, while the number of publications related to coronaviruses reached significant levels thanks to the 111 increased interest following the SARS and, in particular, CoViD-19 epidemic (more than 4900 in the first 4 months of 112 2020 only), the number of published studies on the presence and resistance of coronaviruses in WW is currently almost 113 limited (only 13 from 2000 till now) (Fig.1) . This shortage becomes even more evident if studies on the presence of 114 coronavirus in SS are quantified. Using "coronavirus AND sludge" in Scopus®, only 4 results were identified. The (Zou et al., 2020) . While the viral load in the respiratory tract tends to run out more quickly, 137 All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. The answer entails the availability of a standard technique for extract and quantify the virus in such a complex matrix, 153 and, in particular, to assess its pathogenicity. As reported above, SARS-CoV-2 can reach the sewerage via faeces, and, 154 possibly, urine, beside other human excreta (Table 2) (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. 195 All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint The samples were taken immediately after the treatment phases and therefore other factors that could accelerate the 252 disappearance of the virus in the hypothesis in which they are spread on the soil such as for example pH variations, 253 All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint solar irradiation, and heat were not taken into consideration. HCoV-HKU1 was again identified by Bibby and Peccia 254 (2013) in anaerobically digested SS. They expressed concern due to the high load of virus in treated SS that could be 255 transmitted by the aerosols emitted during the land application. However, also in this case, the infectivity of the viruses, 256 the influence of the anaerobic digestion temperature and meteorological conditions on the resistance of the virus were 257 not defined. CoV-2 and SARS-CoV focus specifically on SS but it is very likely that, beside temperature (responsible for protein 282 All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint Minimization of municipal sewage sludge by means 369 of a thermophilic membrane bioreactor with intermittent aeration Biosolids: what are the different types of 372 reuse? 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(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted doi: medRxiv preprint Kushmaro, A., 2020. Regressing SARS-CoV-2 sewage measurements onto COVID-19 burden in the population: 480 a proof-of-concept for quantitative environmental surveillance Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-483 2): An Update SARS-CoV-2 RNA concentrations in primary 486 municipal sewage sludge as a leading indicator of COVID-19 outbreak dynamics Survival of Viruses in Water Removal of phages and viral pathogens in a full-scale 491 MBR: Implications for wastewater reuse and potable water Stability and inactivation of 494 SARS coronavirus Metropolitan Wastewater 496 Analysis for COVID-19 Epidemiological Surveillance SARS-CoV-2 RNA titers in 498 wastewater anticipated COVID-19 occurrence in a low prevalence area COVID-19 and Italy: what next? Mechanism of virus inactivation in wastewater sludges CoV-2 virus in wastewaters and rivers No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted Survival of human enteric viruses in the environment and food Future perspectives of wastewater-based epidemiology: Monitoring infectious 510 disease spread and resistance to the community level Review article: gastrointestinal features in COVID-19 and the possibility of 513 faecal transmission Biosolids Applied to Land Detection of SARS-CoV-2 in Different Types of 517 Clinical Specimens Study on the resistance of 520 severe acute respiratory syndrome-associated coronavirus WHO Director-General's opening remarks at the media briefing on COVID-19 -11 WHO, 2020b. WHO Coronavirus Disease (COVID-19) -Dashboard Water, sanitation, hygiene and waste management for COVID-19 Guidelines for environmental surveillance of poliovirus circulation Emerging investigators series: the source and fate of pandemic viruses 531 in the urban water cycle SARS-CoV-2 titers in wastewater are 534 All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity doi: medRxiv preprint higher than expected from clinically confirmed cases Prolonged presence of SARS-CoV-2 viral RNA in faecal 538 samples 540 Evaluation of lockdown impact on SARS-CoV-2 dynamics through viral genome quantification in Paris 541 wastewaters Evidence for Gastrointestinal Infection of SARS-CoV-2 Clinical findings in a group of patients infected with the 2019 546 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series Characteristics of pediatric SARS-CoV-2 infection and potential evidence 550 for persistent fecal viral shedding Virus shedding patterns in nasopharyngeal and fecal 552 specimens of COVID-19 patients SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected 558 Patients No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted All rights reserved. No reuse allowed without permission.(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. 562 All rights reserved. No reuse allowed without permission.(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint 567 Fig. 1 : Comparison of the trends of research papers, reviews, books and conference proceedings published up to 20 th 568 May 2020 and their distribution in the world. All data were obtained introducing the words "coronavirus", 569 "coronavirus AND wastewater", "coronavirus AND faeces", and "coronavirus AND urine" in Scopus ® [two-column 570 fitting image] 571 All rights reserved. No reuse allowed without permission.(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint this version posted June 8, 2020. . https://doi.org/10.1101/2020.06.04.20122218 doi: medRxiv preprint