Use of Wastewater Metrics to Track COVID-19 in the US.
Use of Wastewater Metrics to Track COVID-19 in the US.
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DOI：
10.1001/jamanetworkopen.2023.25591
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发表时间：
2023-07-03
影响因子：
13.8
通讯作者：
中科院分区：
文献类型：
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向疾病控制和预防中心的国家废水监测系统报告的废水监测指标是否与美国各县的COVID-19高社区病例和住院率相关？在这项队列研究中，2022年1月至9月对22个州的268个县进行了时间序列分析，SARS-CoV-2废水指标准确反映了2022年初的高临床发病率，但随着家庭检测和疫苗接种的增加，这种关联随着时间的推移而下降。这些研究结果表明，废水监测可以提供一个准确的评估县SARS-CoV-2的发病率，并可能是最好的度量监测数量的循环病毒的家庭测试增加和疾病的严重程度下降，因为疫苗接种和治疗。这项队列研究使用时间序列分析来研究县级废水指标与全国范围内COVID-19病例和住院率之间的关联，无论是在家庭检测广泛使用之前还是之后。家庭COVID-19检测的广泛使用阻碍了社区COVID-19发病率的确定。在广泛使用家庭检测之前和之后，研究县级废水指标与全国高病例和住院率之间的关联。这项具有时间序列分析的观察性队列研究于2022年1月至9月在参与美国疾病控制和预防中心国家废水监测系统的22个州的268个县进行。参与者包括这些美国县的人口。根据相对于县最大值的病毒废水浓度（即废水百分位数）和SARS-CoV-2的15天百分比变化（即百分比变化）确定的县循环SARS-CoV-2水平。COVID-19的高县发病率，通过按日历季度分层的二分报告病例（当前病例≥200/100 000人口）和住院率（≥10/100 000人口滞后2周）证明。在2022年第一季度，使用废水百分位数检测到高报告病例（曲线下面积[AUC]，0.95; 95%CI，0.94-0.96）和住院率（AUC，0.86; 95%CI，0.84-0.88）。百分比变化指标表现不佳，AUC范围为0.51（95% CI，0.50-0.53）至0.57（95% CI，0.55-0.59），从0.50（95%CI，0.48-0.52）至0.55（95%CI，0.53-0.57）。检测高病例率的约登指数为废水百分位数51%（敏感性，0.82; 95%CI，0.80-0.84;特异性，0.93; 95%CI，0.92-0.95）。一个模型，包括这两个指标的表现并不比单独使用废水百分位数。对于2022年第二季度（AUC，0.84; 95%CI，0.82-0.86）和第三季度（AUC，0.72; 95%CI，0.70-0.75）的病例，废水百分位数的表现随时间推移而下降。在这项研究中，全国范围内，县废水水平相对于县最高水平与2022年第一季度的高COVID-19病例和住院率相关，但随后几个季度废水和临床指标之间的分离度越来越大，这可能反映了病例漏报率增加，检测减少，以及疫苗和治疗可能降低感染的毒力。本研究提供了一种策略，可操作县污水百分位数，以提高社区SARS冠状病毒-2感染流行的准确评估时，传统的监测数据的可靠性正在下降。
Are wastewater surveillance metrics reported to the Centers for Disease Control and Prevention’s National Wastewater Surveillance System associated with high community case and hospitalization rates of COVID-19 across US counties? In this cohort study with a time series analysis of 268 counties in 22 states from January to September 2022, SARS-CoV-2 wastewater metrics accurately reflected high clinical rates of disease early in 2022, but this association declined over time as home testing and vaccination increased. These findings suggest that wastewater surveillance can provide an accurate assessment of county SARS-CoV-2 incidence and may be the best metric for monitoring amount of circulating virus as home testing increases and disease acuity decreases because of vaccination and treatment. This cohort study uses time series analysis to examine the association of county-level wastewater metrics with COVID-19 case and hospitalization rates nationwide both before and after widespread use of at-home tests. Widespread use of at-home COVID-19 tests hampers determination of community COVID-19 incidence. To examine the association of county-level wastewater metrics with high case and hospitalization rates nationwide both before and after widespread use of at-home tests. This observational cohort study with a time series analysis was conducted from January to September 2022 in 268 US counties in 22 states participating in the US Centers for Disease Control and Prevention’s National Wastewater Surveillance System. Participants included the populations of those US counties. County level of circulating SARS-CoV-2 as determined by metrics based on viral wastewater concentration relative to the county maximum (ie, wastewater percentile) and 15-day percentage change in SARS-CoV-2 (ie, percentage change). High county incidence of COVID-19 as evidenced by dichotomized reported cases (current cases ≥200 per 100 000 population) and hospitalization (≥10 per 100 000 population lagged by 2 weeks) rates, stratified by calendar quarter. In the first quarter of 2022, use of the wastewater percentile detected high reported case (area under the curve [AUC], 0.95; 95% CI, 0.94-0.96) and hospitalization (AUC, 0.86; 95% CI, 0.84-0.88) rates. The percentage change metric performed poorly, with AUCs ranging from 0.51 (95% CI, 0.50-0.53) to 0.57 (95% CI, 0.55-0.59) for reported new cases, and from 0.50 (95% CI, 0.48-0.52) to 0.55 (95% CI, 0.53-0.57) for hospitalizations across the first 3 quarters of 2022. The Youden index for detecting high case rates was wastewater percentile of 51% (sensitivity, 0.82; 95% CI, 0.80-0.84; specificity, 0.93; 95% CI, 0.92-0.95). A model inclusive of both metrics performed no better than using wastewater percentile alone. The performance of wastewater percentile declined over time for cases in the second quarter (AUC, 0.84; 95% CI, 0.82-0.86) and third quarter (AUC, 0.72; 95% CI, 0.70-0.75) of 2022. In this study, nationwide, county wastewater levels relative to the county maximum were associated with high COVID-19 case and hospitalization rates in the first quarter of 2022, but there was increasing dissociation between wastewater and clinical metrics in subsequent quarters, which may reflect increasing underreporting of cases, reduced testing, and possibly lower virulence of infection due to vaccines and treatments. This study offers a strategy to operationalize county wastewater percentile to improve the accurate assessment of community SARS-CoV-2 infection prevalence when reliability of conventional surveillance data is declining.
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影响因子：
3.7
作者：
Donaldson AL;Hardstaff JL;Harris JP;Vivancos R;O'Brien SJ
通讯作者：
O'Brien SJ
使用分布式滞后模型对 SARS-CoV-2 RNA 废水沉降固体进行监测频率以及对预测的 COVID-19 发病率的影响。
DOI：
10.1021/acsestwater.2c00074
发表时间：
2022-11-11
期刊：
ACS ES&T WATER
影响因子：
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作者：
Schoen, Mary E;Wolfe, Marlene K;Li, Linlin;Duong, Dorothea;White, Bradley J;Hughes, Bridgette;Boehm, Alexandria B
通讯作者：
Boehm, Alexandria B
影响因子：
11.8
作者：
Sims, Natalie;Kasprzyk-Hordern, Barbara
通讯作者：
Kasprzyk-Hordern, Barbara
影响因子：
10.4
作者：
通讯作者：
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影响因子：
12.7
作者：
Kotlarz, Nadine;Holcomb, David A.;Harris, Angela
通讯作者：
Harris, Angela