SARS-CoV-2 Surveillance in Hospital Wastewater: CLEIA vs. RT-qPCR

Abstract

The utilization of wastewater as a community surveillance method grew during the COVID-19 epidemic. COVID-19 hospitalizations are closely connected with wastewater viral signals, and increases in wastewater viral signals can serve as an early warning indication for rising hospital admissions. While reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) is the most often used approach for detecting SARS-CoV-2 in wastewater, chemiluminescence enzyme immunoassay (CLEIA) is an alternative automated method. In two assays, 92 wastewater grab samples from a hospital were investigated for the presence of SARS-CoV-2, expected for continuous and monitoring SARS-CoV-2 surveillance. One was in the RT-qPCR nucleic acid test, and another was in the CLEIA assay quantitative antigen test. In 24/92 (26.09%) of the wastewater samples, RT-qPCR identified at least two SARS-CoV-2 genes (ORF1ab, N, or S genes). CLEIA, on the other hand, detected SARS-CoV-2 antigen in 39/92 (42.39%) of the samples. CLEIA demonstrated a low sensitivity and specificity of sensitivity of 54.2% (95% CI: 44.0–64.3%) and 61.8% (95% CI: 51.8–71.7%), respectively, as compared to RT-qPCR. The κ coefficient indicated slight agreement between assay. Then, the CLEIA assay cannot replace molecular-based testing like RT PCR for determining SARS-CoV-2 in hospital wastewater.