SARS-CoV-2 wastewater surveillance in a central Chinese metropolis: variant responses and correlation with clinical cases.

This study analyzed SARS-CoV-2 surveillance results in the urban wastewater of Zhengzhou, central China, to explore its association with community COVID-19 incidence and evaluate its early warning performance across different SARS-CoV-2 variant epidemic phases.

Weekly monitoring was conducted at five representative wastewater treatment plants from May 2024 to July 2025, yielding 325 samples. Viral loads of the ORF1ab and N genes were quantified using RT-qPCR, with statistical analyses performed included Spearman correlation, ANOVA, and cross-correlation function.

The two target genes showed high consistency and significant positive correlation with 14-day cumulative COVID-19 incidence. However, significant variant and marked heterogeneity was observed across variant periods and gene targets, with the N gene outperforming ORF1ab in stability. Wastewater viral signals preceded clinical cases by one week.

These findings supported the application value of wastewater-based epidemiology in post-pandemic COVID-19 surveillance, indicate its potential early warning capacity, and reveal notable heterogeneity in surveillance performance across viral variants and target genes.
Chronic respiratory disease
Care/Management
Advocacy

Authors

Zhang Zhang, Zhang Zhang, Zhao Zhao, Ma Ma, Lv Lv, Ma Ma, Zhang Zhang, Han Han
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