key: cord-0870308-bzuim20s
authors: Dhama, Kuldeep; Patel, Shailesh Kumar; Yatoo, Mohd. Iqbal; Tiwari, Ruchi; Sharun, Khan; Dhama, Jaideep; Natesan, Senthilkumar; Malik, Yashpal Singh; Singh, Karam Pal; Harapan, Harapan
title: SARS-CoV-2 existence in sewage and wastewater: a global public health concern?
date: 2020-12-10
journal: J Environ Manage
DOI: 10.1016/j.jenvman.2020.111825
sha: 57e83f8a576d91b123aaa2945105f2f8bad4c4b7
doc_id: 870308
cord_uid: bzuim20s

The SARS-CoV-2/ COVID-19 pandemic has spread across the globe and affected millions of individuals as of the efficient virus transmission potential mediated via multiple virus shedding routes. The presence of SARS-CoV-2 in the stool samples and its prolonged shedding in environmental compartments like sewage and wastewater signifies a potential threat adding to the transmission cycle of this novel virus. The potential role played by the asymptomatic COVID-19 patients in transmitting the disease via the fecal-oral route is now under investigation. Hence, in the present scenario, wastewater-based epidemiology, and sewage surveillance may provide valuable insights into the prevalence of SARS-CoV-2 among the human population and could serve as a sensitive surveillance system and a crucial early warning tool. Further studies are required to determine the survival of SARS-CoV-2 in the environment, transmissibility through wastewater, and the potential to infect humans via the fecal-oral route. Appropriate frameworks with regards to evaluation and analysis of SARS-CoV-2 will help implement appropriate intervention strategies and necessary sanitation practices to ensure virus free clean water supply to have a check on the further spread of this pandemic virus.

The involvement of the GIT has been confirmed by detecting the virus in 53% (9 out 68 of 17) stool samples of COVID-19 cases, although with a lower viral load compared to 69 respiratory samples, throat, and sputum (Pan et al., 2020) . The viral RNA has been detected 70 in fecal samples from both symptomatic and asymptomatic patients (Gao et al., 2020; 71 Holshue et al., 2020; Zhang et al., 2020a; D'Amico et al., 2020) . Furthermore, the viable virus 72 has also been detected in stool samples from patients with COVID-19 (Wang et al., 2020; Wu 73 et al., 2020) . Additionally, shedding of the virus in the feces for several days after the Viral shedding can occur via the fecal route in patients whose oropharyngeal samples 81 tested negative for SARS-CoV-2 and up to 7 days after negative conversion in pharyngeal 82 swabs (Chen et al., 2020b) . A study reported the median duration of viral shedding in the 83 stool was 22 days in comparison to the 18 and 16 days in respiratory airways and serum 84 samples, respectively (Zheng et al., 2020b) . Hence, to prevent the possibility of a false 85 negative result during the initial screening, stool samples should be tested to complement 86 other tests for enabling the early diagnosis of COVID-19. Moreover, the fecal sample 87 collection is non-invasive and can be performed by the patients themselves (Bonato et al., 88 in sewage samples represents a collection of virus shed by many people in the community; 131 hence it is equivalent to pooled testing. Moreover, global investigators highlighted that 132 sewage surveillance could reveal the true scale of the COVID-19 pandemic and helps in 133 designing crucial policy makings to contain the virus (Mallapaty, 2020). 

COVID-19)

Viral load dynamics and disease severity in patients 580 infected with SARS-CoV-2 in Zhejiang province, China

COVID-19 and the cardiovascular 583 system

SARS-CoV-2 viral 586 load in upper respiratory specimens of infected patients