摘要：SummaryVirus surveillance in wastewater can be a useful indicator of the development of the COVID-19 pandemic in communities. However, knowledge about how the amount of SARS-CoV-2 RNA in wastewater relates to different data on the burden on the health system is still limited. Herein, we monitored the amount of SARS-CoV-2 RNA and the spectrum of virus variants in weekly pooled wastewater samples for two years from mid-February 2020 and compared them with several clinical data. The two-year monitoring showed the weekly changes in the amount of viral RNA in wastewater preceded the hospital care needs for COVID-19 and the number of acute calls on adult acute respiratory distress by 1-2 weeks during the first three waves of COVID-19. Our study demonstrates that virus surveillance in wastewater can predict the development of a pandemic and its burden on the health system, regardless of society’s test capacity and possibility of tracking infected cases.Graphical abstractDisplay OmittedHighlights•The weekly variation of viral RNA preceded hospital care needs for COVID-19•Virus surveillance in wastewater could predict the burden to urgent call center•Virus surveillance in wastewater could predict the development of a pandemic•SARS-CoV-2 variants in wastewater coincided with their circulation in societiesPublic health; Environmental medicine; Virology
