Evaluation of a field deployable, high-throughput RT-LAMP device as an early warning system for COVID-19 through SARS-CoV-2 measurements in wastewater

• Published in: The Science of the total environment 2024-09, Vol.944, p.173744, Article 173744
• Main Authors: Boza, J.M., Amirali, A., Williams, S.L., Currall, B.B., Grills, G.S., Mason, C.E., Solo-Gabriele, H.M., Erickson, D.C.
• Format: Article
• Language: English
• Subjects: COVID-19 - diagnosis; Humans; Molecular Diagnostic Techniques - instrumentation; Molecular Diagnostic Techniques - methods; Nucleic Acid Amplification Techniques - instrumentation; Nucleic Acid Amplification Techniques - methods; RNA, Viral - analysis; RT-LAMP; RT-qPCR; SARS-CoV-2; Viral Load; Wastewater; Wastewater - virology; Wastewater-based surveillance
• ISSN: 0048-9697; 1879-1026; 1879-1026
• DOI: 10.1016/j.scitotenv.2024.173744

Quantification of SARS-CoV-2 RNA copies in wastewater can be used to estimate COVID-19 prevalence in communities. While such results are important for mitigating disease spread, SARS-CoV-2 measurements require sophisticated equipment and trained personnel, for which a centralized laboratory is necessary. This significantly impacts the time to result, defeating its purpose as an early warning detection tool. The objective of this study was to evaluate a field portable device (called MINI) for detecting SARS-CoV-2 viral loads in wastewater using real-time reverse transcriptase loop-mediated isothermal amplification (real-time RT-LAMP). The device was tested using wastewater samples collected from buildings (with 430 to 1430 inhabitants) that had known COVID-19-positive cases. Results show comparable performance of RT-LAMP against reverse transcriptase polymerase chain reaction (RT-qPCR) when detecting SARS-CoV-2 copies in wastewater. Both RT-LAMP and RT-qPCR detected SARS-CoV-2 in wastewater from buildings with at least three positive individuals within a 6-day time frame prior to diagnosis. The large 96-well throughput provided by MINI provided scalability to multi-building detection. The portability of the MINI device enabled decentralized on-site detection, significantly reducing the time to result. The overall findings support the use of RT-LAMP within the MINI configuration as an early detection system for COVID-19 infection using wastewater collected at the building scale. [Display omitted] •Decentralized testing of SARS-CoV-2 in wastewater•Wastewater as an early warning system for COVID-19•Wastewater-based surveillance as a tool for the allocation of resources•Real-Time RT-LAMP as an alternative approach to RT-qPCR•Rapid decentralized detection of wastewater