Building-level wastewater surveillance using tampon swabs and RT-LAMP for rapid SARS-CoV-2 RNA detection. Issue 1 (3rd December 2021)

• Record Type: Journal Article
• Authors: Bivins, Aaron; Lott, Megan; Shaffer, Marlee; Wu, Zhenyu; North, Devin; Lipp, Erin K.; Bibby, Kyle
• Is Part Of: Environmental science. Volume 8:Issue 1(2022)
• Page Start: 173
• Page End: 183
• Publication Date: 2021-12-03
• Subjects: Water-supply -- Periodicals; Water security -- Periodicals; Water resources development -- Periodicals; Water chemistry -- Periodicals; 553.705
• DOI: 10.1039/d1ew00496d
• Languages: English
• ISSNs: 2053-1400

Abstract

Abstract : This study evaluated a passive sampling and rapid LAMP detection of SARS-CoV-2 for near-source ( i.e., building-level) wastewater based epidemiology applications. Abstract : Wastewater surveillance for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA has demonstrated useful correlation with both coronavirus disease 2019 (COVID-19) cases and clinical testing positivity at the community level. Wastewater surveillance on college campuses has also demonstrated promising predictive capacity for the presence and absence of COVID-19 cases. However, to date, such monitoring has most frequently relied upon composite samplers and reverse transcription quantitative PCR (RT-qPCR) techniques, which limits the accessibility and scalability of wastewater surveillance, particularly in low-resource settings. In this study, we trialed the use of tampons as passive swabs for sample collection and reverse transcription loop-mediated isothermal amplification (RT-LAMP), which does not require sophisticated thermal cycling equipment, to detect SARS-CoV-2 RNA in wastewater. Results for the workflow were available within three hours of sample collection. The RT-LAMP assay is approximately 20 times less analytically sensitive than RT-droplet digital PCR. Nonetheless, during a building-level wastewater surveillance campaign concurrent with independent weekly clinical testing of all students, the method demonstrated a three-day positive predictive value (PPV) of 75% (excluding convalescent cases) and same-day negative predictive value (NPV) of 80% for incident COVID-19 cases. These predictive values are comparable to that reported by wastewater monitoring using RT-qPCR. These observations suggest that even with lower analytical sensitivity the tampon swab and RT-LAMP workflow offers a cost-effective and rapid approach that could be leveraged for scalable building-level wastewater surveillance for COVID-19 potentially even in low-resource settings.