key: cord-0740399-89w07tli authors: O'Brien, Megan; Rundell, Zachary C.; Nemec, Michelle D.; Langan, Laura M.; Back, Jeffrey A.; Lugo, Joaquin N. title: A comparison of four commercially available RNA extraction kits for wastewater surveillance of SARS-CoV-2 in a college population date: 2021-08-12 journal: Sci Total Environ DOI: 10.1016/j.scitotenv.2021.149595 sha: 7d755f62584bee293efe72be069c071758cbdc13 doc_id: 740399 cord_uid: 89w07tli Localized wastewater surveillance has allowed for public health officials to gain a broader understanding of SARS-CoV-2 viral prevalence in the community allowing public health officials time to prepare for impending outbreaks. Given variable levels of virus in the population through public health interventions, proper concentration and extraction of viral RNA is a key step in ensuring accurate detections. With many commercial RNA extraction kits and methodologies available, the performance of 4 different kits were evaluated for SARS-CoV-2 RNA detection in wastewater, specifically focusing on their applicability to lower population densities such as those at university campus dorms. Raw wastewater samples were collected at 4 sites on a college campus over a 24 hour period as a composite sample. Included in these sites was an isolation site that housed students that tested positive for Covid-19 via nasopharyngeal swabs. These samples were analyzed using the following kits: Qiagen All Prep PowerViral DNA/RNA kit, New England BioLabs Monarch RNA MiniPrep Kit, and Zymo Quick RNA-Viral Kit, and the Zymo Quick-RNA Fecal/Soil Microbe MicroPrep Kit. All four sites were processed according to the manufacturer's guidelines. Extractions were then quantified with RT-qPCR one-step reactions using an N2 primer and a linearized plasmid standard. While the Zymo Quick-RNA Fecal/Soil Microbe MicroPrep Kit (also known as the Zymo Environ Water RNA Kit) only recovered approximately 73% (±38%) SARS-CoV-2 RNA compared to the Zymo Quick-RNA Viral kit, it was the most time efficient kit to yield comparable results. This extraction kit had a cumulative processing time of approximately 5 h compared, while the other three kits had processing times between approximately 9 and 9.5 h. Based on the current research, the most effective kits for smaller population densities are pellet based and include a homogenization, inhibitor removal, and RNA preservation step. On January 31, 2020, the WHO declared COVID-19 a Public Health Emergency of International Concern (Jee, WHO, 2020) . Widespread testing of those with and without COVID-19 symptoms, in combination with the numerous vaccine roll outs is vital to curtailing the current pandemic and future outbreaks. The current estimate of infected individuals is believed to be underestimated worldwide, with numerous nations initially encouraging testing for those only with symptoms. Therefore, those who are presymptomatic or asymptomatic are often less likely to be identified, thus posing a significant potential for transmission, with studies estimating that asymptomatic or presymptomatic transmission could be responsible for up to 50% of new cases (Ghandi et. al 2020 , Moghadas et. al 2020 . A variety of diagnostic testing methods are available to determine if individuals are infected with COVID-19. Current diagnostic testing involves the collection and PCR analysis of infected cells and bodily fluids for the SARS-CoV-2 virus by drawing blood or collecting samples from the nose, mouth, throat, or lungs (Ravi et. al 2020) . While useful, these testing methods are hazardous, resource-intensive, and invasive (Binnicker 2020) . Wastewater based epidemiology offers a promising method of Covid-19 surveillance that may solve some of these pressing issues. Although a relatively new field, it has conventionally been successfully used to estimate use of legal and illegal drugs of abuse and to evaluate human exposure to contaminants and pathogens as summarized in Lorenzo et al. (2019) . Active monitoring of SARS-CoV-2 RNA in wastewater can be a useful tool for identifying hotspots and has been demonstrated to serve as an early warning system for new outbreaks (Xagorarki et. al 2019 , Venugopal et. al 2020 , Betancourt et. al 2020 . This method is unique as it allows researchers to survey large groups of people quickly with fewer resources and staff. Wastewater J o u r n a l P r e -p r o o f based epidemiology is also less intrusive compared to nasal swabs and reduces occupational exposure to SARS-CoV-2. Perhaps the largest benefit of wastewater surveillance is its efficiency and ability to view community prevalence. Thus, areas with higher viral copies may be focused on for individual testing efforts and public health interventions. Wastewater surveillance works due to SARS-CoV-2 RNA being detectable in the feces of both symptomatic and asymptomatic individuals (Hart et. al 2020 , Mizumoto et. al 2020 , Treibel et. al 2020 , even after the individuals no longer had respiratory symptoms (Zheng et. al 2020 , Mesoraca et. al 2020 , Jones et. al 2020 . Wastewater based epidemiology is a powerful tool that can provide vital information about the spread of Covid-19 and can be useful in prioritizing diagnostic PCR testing. It has demonstrated its ability to effectively aide in detecting affected individuals so students could be tested or isolated to prevent further spread on a college campus (Betancourt et. al 2020) . Unfortunately, a need exists for standardized techniques in applying this method to Covid-19 surveillance (Ahmed et. al 2020a) . As populations contributing to the wastewater vary in their characteristics, so does the overall matrix of the wastewater sample (Kitajima et. al 2020) . Consequently, numerous methods of sample processing exist, which can make it difficult for researchers to choose an optimal method for accurate detection. Furthermore, sampling in small population densities adds another layer of complexity to detection due to a potential for lower viral loads than typical in municipalities. Monitoring in communities with low incidence has previously demonstrated high PCR Ct values and hence variable or unquantifiable data being The selection of an appropriate RNA isolation kit is a key component of processing samples that can have a major impact on the results yielded. This study aims to provide an overview of the efficacy and efficiency of four common RNA isolation kits produced by Zymo, Qiagen, and New England Biolabs when surveilling a small population for SARS-CoV-2 in wastewater. The endpoints examined in this study include a comparison of viral detection across all four kits as well as a qualitative description of each method. Wastewater was collected from 4 buildings in Waco, Texas on Baylor University's campus. Sites A-C were collected from 3 dormitories and with a total, combined population of approximately 850 students at time of collection. Included in these sites was a dormitory that consistently yielded non-detectable values (site B). An additional isolation site, (Site I) was also included, this site housed an unknown number of students who were isolated due to active SARS-CoV-2 infections. Composite 8.64-liters of untreated raw wastewater samples were collected over a 24-hr period in polypropylene bottles from 11:00 am on 10/6/2020 to 10:45 am on 10/7/2020. ISCO model 6712 automatic samplers were programmed to collect composite samples in 90 mL increments every 15 minutes. The sample bottle chamber was filled with ice to keep the samples cold. Upon collection, each composite sample was mixed by hand and an aliquot was poured into a 250 mL polypropylene centrifuge bottle (Fisherbrand, catalog # 14-375-352) and stored on ice. Samples were processed approximately 1 hour after collection. J o u r n a l P r e -p r o o f Following collection, raw wastewater samples were concentrated by centrifuging each 250 mL sample in the original bottle at 4˚C for 45 minutes on a coast deceleration setting so as not to disturb the pellet (AVANTI JXN 26, JS-7.5 rotor, 4700 RCF). Supernatant (150 mL) was collected and aliquoted for use in three of the extraction kits. The remaining 100 mL pellet was resuspended and used for the pellet-based extraction kit. The resulting 150 mL filtrate was further concentrated using ultrafiltration with AMICON 15 mL conical filtration tubes (Sigma Aldrich; UFC901024). Filtrate was loaded in increments of 15 mL until the total collection volume had been reduced to~ 1000 µL (5000 RCF, Eppendorf A-4-62 swing-bucket rotor with adaptors). In some cases, the filters became clogged and a new ultrafilter was required and when necessary the sample was transferred to a new filtration tube. Concentrate was then aliquoted (~250 µL) and RNA exactions carried out using extraction kits 1-3: Qiagen All Prep PowerViral DNA/RNA kit (80244) For the pellet, 45 out of the 100 mL of the resuspended pellet was collected into 50 mL conical tubes. Urine conditioning buffer (3.150 mL, D3061-1-140) was added thoroughly mixed, then centrifuged (5000 RCF x 15 min, RT; Eppendorf FA-45-6-30 fixed rotor). Following centrifugation, the remaining filtrate was removed (~47.9 mL) leaving ~ 250 µL concentrated pellet composite. To this, 750 µL of RNA/DNA shield (Zymo, R1100-250) was then added to the sample and held at 4˚C until extraction. All extractions took place in an RNAse, DNAse-free hood environment, following manufacturers guidelines. A field blank using in-house tap water was run for primary concentration/processing integrity. RNA extraction blanks using nuclease free water were included with each extraction batch and kit. J o u r n a l P r e -p r o o f Quantification of viral load was determined via RT-qPCR (QuantStudios 6 Flex) using New England BioLabs Enzyme and Probe Master kit (New England Biolabs, Catalog E3006X) with IDT N2 RUO primers (IDT, catalog #10006713). Each plate contained triplicates of each condition; whose CT's were averaged to get the mean CT for each sample for each extraction method. The standards used contained a linearized 200,000 cp/uL N plasmid standard (IDT, catalog #10006625) which was diluted into a 10,000 copies/µL stock. Each plate's standard curve was conducted using an 8 series dilution, starting with 10,000 copies/µL to 2.441 copies/µL. For the LOQ, CT values corresponding with a value of less than 2.441 copies/µL were listed as "not detected" values. In order to accurately assess whether inhibitors are acting upon collected samples, 1:2 dilutions were made from the RNA extract directly prior to plate analysis. Non-template controls confirmed PCR integrity. More information on PCR analysis can be found in the Supplemental Information. To benchmark the performance of the kits, the controls (viz. field blanks, extraction blanks and PCR blanks, and no template controls) were first all confirmed to be non-detectable for SARS-CoV-2. Thereafter, the individual sites were examined. Site B acts as a control for the methodology, with consistency low incidence levels historically recorded. For this sampling location, Site B resulted in a non-detectable sample across all RNA extraction kits evaluated (Table 1) Table 4 . In regards to the isolation site, the New England BioLabs kit obtained the highest viral load at 45,000,000 copies/L in the original sample, and 28,000,000 copies/L in the diluted sample. However, New England BioLabs kit was the most variable in terms of consistency between dilutions. Here, the original sample carried a higher load (45.3%) than the diluted J o u r n a l P r e -p r o o f Journal Pre-proof sample. The Zymo Fecal kit had the least variation between the dilution series (0.99%), as we saw with the site comparisons. The impact of PCR inhibitors was examined using the isolation location (Site I), with little difference observed in the Zymo Fecal kit between concentrate and diluted sample in comparison to other kits. Interestingly, cp/L at the isolation site is markedly lower in the Qiagen kit compared to others which is surprisingly considering that this kit has been used heavily in wastewater testing of large municipalities. Impact of PCR inhibitors were examined using the isolation location (Site I), with little difference observed in the Zymo Fecal kit between concentrate and diluted sample in comparison to other kits. Interestingly, cp/L at the isolation site is markedly lower in the Qiagen kit compared to others which is surprisingly considering that this kit has been used heavily in wastewater testing of large municipalities. Normalizing the data by population is another key in determining hotspots for potential outbreaks. If the viral load per resident is high relative to the surrounding sites, this could be a potential indicator of an upcoming outbreak. Following normalizing to population size, Site A population (539) and Site C population (153), there is consistent differences in viral loads between extraction kits and between sites, with the Qiagen kit reporting markedly lower viral levels then the other kits examined. (Figure 2 ). Previous work has found that there is a lack of qualitative information for wastewater concentration and RNA extraction methodologies . Therefore, we have provided qualitative information based on previous experiments. All times are approximate, and prices are listed as current for time of publication (Table 2) . Footnotes can be found in Supplemental Information. These times are total working hours and assume no breaks in between each section of processing, for only four samples. There is also the assumption that the technician has conducted the protocols prior to beginning the process. It should be noted that at the time of publication, the Zymo Quick-RNA Fecal/Soil Microbe MicroPrep Kit has been renamed as the Zymo Environ Water RNA Kit (Zymo Research, catalog #R2042), in which the only difference is that the urine conditioning buffer and DNA/RNA shield are included with the kit purchase. Filtrate-based methods that use ultrafiltration considerably increased processing times due to long centrifuge runs and the potential for clogging filters ( Table 2 ). The Zymo Quick-RNA Fecal/Soil MicroPrep kit required the most time, but yielded results more consistently across the board. This methodology also does not require the use of a floor centrifuge, meaning it may be available to a wider audience looking to start local surveillance. ultrafiltering step. Ultrafilter clogging was an issue with ultrafiltering, and loss of viral load is assumed with each tube transfer. Consumables associated with primary concentration, such as ultrafilters and 50 mL Falcon tubes, are becoming increasingly difficult to obtain due to backordering. Finding effective methods to accurately identify low SARS-CoV-2 viral loads in wastewater are important for sectors such as hospitals, nursing homes, or schools, which have a lower flow rates than municipal wastewater treatment plants that are normally investigated during broad surveillances. The Qiagen All Prep PowerViral kit columns select for both DNA and RNA, where RNA could be potentially lost. New England BioLabs suggests the use of their RNA Cleanup Kit to aide in better recoverprevent RNA degradatioThe Zymo Quick-RNA Fecal/Soil MicroPrep Kit included two forms of RNA preservation (DNA/RNA shield and urine conditioning buffer) which may have aided in its higher recoveries. Based on these results, we would recommend choosing a kit that specifically targets RNA extraction, and not a combined kit. This would allow for DNA removal as well, with which we saw increased detection in RNA viral loads. Homogenization of samples prior to extraction can aide in breaking viral capsids and releasing viral RNA. The Qiagen kit did not include filtrate homogenization steps, which could have affected its lower detection values. A kit that includes an inhibitor removal component is also vital, even in samples with low population density. The Monarch Kit did not include an inhibitor removal step during the extraction process, whereas the other kits involved at least one RNA inhibitor removal step. This would indicate that inhibitor removal was indeed necessary to see higher amplifications in CT values, since diluting inhibited samples is known to increase the efficiency of primer binding to cDNA, where inhibitors themselves are then diluted (Hata et. al Since viral shedding through feces can be seen in both symptomatic and asymptomatic/presymptomatic patients, health officials can see larger trends in community prevalence than through nasal swabbing alone (Hart et. al 2020 , Mizumoto et. al 2020 , Treibel et. al 2020 . Duration of viral shedding in symptomatic patients can vary anywhere from a matter 14-21 days (Wu et. al 2021) . It is indicated that viral shedding through feces precedes symptoms of COVID-19, and thus is imperative that precautionary measures be taken as soon as possible to prevent widespread contagion throughout the sample population, even in low prevalence areas (Randazzo et. al 2020) . Results from this study were used to choose a concentration method and RNA extraction kit for Baylor University's campus wide wastewater surveillance program for the spring of 2021. The results of this study show that a pellet-based RNA extraction kit that includes an inhibitor removal and RNA preservation step may yield the most consistent, timely, and accurate results. These additional steps may be why the Zymo Quick-RNA Fecal/Soil Microbe MicroPrep J o u r n a l P r e -p r o o f Journal Pre-proof (also called the Zymo Environ Water RNA kit) was the most effective and efficient kit with the samples we used in the study. In contrast, the least effective kit was the Qiagen All Prep PowerViral DNA/RNA Kit. This was likely due to the absences of a preservation step and inefficiencies stemming from the kit selecting for both DNA and RNA. For filtrate based methods, we recommend using the Zymo Quick-RNA Viral kit as an effective and efficient method of wastewater based epidemiological analysis in concentrated wastewater samples, especially in smaller population densities. J o u r n a l P r e -p r o o f Surveillance of SARS-CoV-2 RNA in Wastewater: Methods Optimization and Quality Control Are Crucial for Generating Reliable Public Health Information Comparison of Virus Concentration Methods for the RT-QPCR-Based Recovery of Murine Hepatitis Virus, a Surrogate for SARS-CoV-2 from Untreated Wastewater COVID-19 Containment on a College Campus via Wastewater-Based Epidemiology, Targeted Clinical Testing and an Intervention Challenges and Controversies to Testing for COVID-19 Quantitative Analysis of SARS-CoV-2 RNA from Wastewater Solids in Communities with Low COVID-19 Incidence and Prevalence Asymptomatic Transmission, the Achilles' Heel of Current Strategies to Control Covid-19 SARS-CoV-2 in Wastewater Settled Solids Is Associated with COVID-19 Cases in a Large Urban Sewershed Wastewater Surveillance for SARS-CoV-2: Lessons Learnt from Recent Studies to Define Future Applications Computational Analysis of SARS-CoV-2/COVID-19 Opportunities and Challenges Organic Substances Interfere with Reverse Transcription-Quantitative PCR-Based Virus Detection in Water Samples WHO International Health Regulations Emergency Committee for the COVID-19 Outbreak Fecal Shedding of SARS-CoV-2 and Its Potential Role in Person-To-Person Transmission and the Environment-Based Spread of COVID-19 SARS-CoV-2 in Wastewater: State of the Knowledge and Research Needs Efficient Detection of SARS-CoV-2 RNA in the Solid Fraction of Wastewater Wastewater-based epidemiology: Current status and future prospects Primary Concentration -The Critical Step in Implementing the Wastewater Based Epidemiology for the COVID-19 Pandemic: A Mini-Review Evaluation of SARS-CoV-2 Viral RNA in Fecal Samples Estimating the Asymptomatic Proportion of Coronavirus Disease 2019 (COVID-19) Cases on Board the Diamond Princess Cruise Ship The Implications of Silent Transmission for the Control of COVID-19 Outbreaks Making Waves: Wastewater-Based Epidemiology for COVID-19 -Approaches and Challenges for Surveillance and Prediction Comparing Analytical Methods to Detect SARS-CoV-2 in Wastewater SARS-CoV-2 RNA Titers in Wastewater Anticipated COVID-19 Occurrence in a Low Prevalence Area Diagnostics for SARS-CoV-2 Detection: A Comprehensive Review of the FDA-EUA COVID-19 Testing Landscape Applicability of Polyethylene Glycol Precipitation Followed by Acid Guanidinium Thiocyanate-Phenol-Chloroform Extraction for the Detection of SARS-CoV-2 RNA from Municipal Wastewater COVID-19: PCR Screening of Asymptomatic Health-Care Workers at London Hospital Novel Wastewater Surveillance Strategy for Early Detection of Coronavirus Disease 2019 Hotspots SARS-CoV-2 and Its Infected World Wastewater-Based Epidemiology for Early Detection of Viral Outbreaks Survivability Partitioning, and Recovery of Enveloped Viruses in Untreated Municipal Wastewater Viral Load Dynamics and Disease Severity in Patients Infected with SARS-CoV-2 in We would like to acknowledge the financial support from Baylor University and for support from Dr. Bryan Brooks and Dr. Kevin Chambliss. We would also like to thank the Molecular Biosciences Center for the use of the equipment in the core and other reagents used in this study.J o u r n a l P r e -p r o o f Journal Pre-proof