Hospital Wastewater Surveillance of SARS-CoV-2 RNA: Association With COVID-19 Cases and Insights into Environmental Persistence

Rozhan  Feizi; Neematollah  Jaafarzadeh; Masoud Panahi  Fard; Niloofar  Neisi; Abdollah  Dargahi; Maryam  Mehrbakhsh

doi:10.18502/jehsd.v10i3.19791

Rozhan Feizi Department of Environmental Health, Behbahan Faculty of Medical Sciences, Behbahan, Iran.
Neematollah Jaafarzadeh Environmental Technologies Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Masoud Panahi Fard Student Research Committee, Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Niloofar Neisi Department of Virology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Abdollah Dargahi Department of Environmental Health, Khalkhal University of Medical Sciences, Khalkhal, Iran.
Maryam Mehrbakhsh Department of Environmental Health, Behbahan Faculty of Medical Sciences, Behbahan, Iran.

DOI: https://doi.org/10.18502/jehsd.v10i3.19791

Keywords: Covid 19; SARS-CoV-2; Hospital; Wastewater; Health Monitoring.

Abstract

Introduction: Analyzing municipal wastewater for the presence of SARS-CoV-2 RNA serves as a cost-effective and timely tool for epidemiological surveillance to mitigate virus-related health risks. Therefore, this study assessed the presence of SARS-CoV-2 RNA in untreated hospital wastewater and its correlation with COVID-19 case numbers over six months at Shahidzadeh Hospital in southwest Iran.

Materials and Methods: In this analytical investigation, a total of 24 grab samples of untreated hospital wastewater were systematically collected over six months, spanning from September 2020 to February 2021. Each sample was subsequently processed and analyzed using a reverse transcription quantitative polymerase chain reaction (RT-qPCR) approach, with specific amplification targeting both the RNA-dependent RNA polymerase (RdRp) gene and the nucleocapsid (N) gene of SARS-CoV-2.

Results: All 24 wastewater samples tested positive for SARS-CoV-2 RNA. Concentrations ranged between 130 to 490 gene copies/100 mL, with mean values increasing from 247 (September) to 425 (February). RNA levels were strongly correlated with hospitalized COVID-19 cases (Spearman’s p < 0.05, R² = 0.87).

Conclusion: These findings highlight the value of hospital wastewater surveillance as a cost-effective epidemiological tool, particularly in settings with limited diagnostic capacity. Future research should investigate viral viability and optimize disinfection strategies to reduce potential environmental risk.