key: cord-0015371-0q828hoh
authors: Davó, Laura; Seguí, Raimundo; Botija, Pilar; Beltrán, María José; Albert, Eliseo; Torres, Ignacio; López-Fernández, Pablo Ángel; Ortí, Rafael; Maestre, Juan Francisco; Sánchez, Gloria; Navarro, David
title: Early detection of SARS-CoV-2 infection cases or outbreaks at nursing homes by targeted wastewater tracking
date: 2021-02-15
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2021.02.003
sha: c02b26c6cfd05521fecd1eede5e14c7ca0593580
doc_id: 15371
cord_uid: 0q828hoh

nan

To the Editor, 23 Nursing homes (NH) have been severely affected by the COVID-19 pandemic, largely 24 due to their congregate nature and the vulnerability of residents [1] . Advanced age, 25 frailty and concurrence of underlying chronic health conditions place NH residents at 26 high risk for developing severe forms of COVID-19 and death. Long-lasting virus 27 shedding of SARS-CoV-2 in urine and feces has been documented in both symptomatic 28 and asymptomatic infected adults [2] . As a result, near-source tracking in the sewers 29 serving particular buildings (i.e. campus dorms, workplaces, correctional facilities, 30 schools) has emerged as an appealing non-invasive tool which when combined with 31 subsequent targeted population screening when SARS-CoV-2 is detected may enable 32 rapid identification and control of facility outbreaks [3] . In this pilot study, we provide 33 evidence demonstrating the feasibility and utility of this wastewater-based 34 epidemiological approach for early identification of isolated cases or outbreaks of (Table 1) . Selection from among the 17 NH supported by the Clínico-Malvarrosa RT-qPCR were performed as previously described [4, 5] . The results are reported as 53 genome copies (GC)/L. The limit of detection of the RT-qPCR assay is 670 GC/L.

As shown in Table 1 Figure 1) . The SARS-CoV-2 outbreak at NHA is currently still active.

The present study has several limitations that must be acknowledged. First, no Yes (June 17 and July 13) ND, not detected; NR, not reported. a RNA extraction from sewage material was carried out using the NucleoSpin RNA virus Kit (MACHEREY-NAGEL, Germany). SARS-CoV-

Nursing Home Care in Crisis in the Wake of COVID-19

RNA samples were analyzed in duplicate. Each RT-qPCR run included negative (nuclease-free water) and positive controls. RT-qPCR targets were quantified by plotting the quantification cycles (C T ) to an external standard curve built with 10

Mengovirus RNA recovery rates were calculated and used as quality assurance parameters according to ISO

RNA was extracted using the Applied Biosystems™ MagMAX™ Viral/Pathogen II Nucleic Acid Isolation Kits coupled with Thermo Scientific™ KingFisher Flex automated instrument

Resident tested for SARS-CoV-2 infection because appearance of symptoms compatible with COVID-19 (fever and cough)