The dominance of co-circulating SARS-CoV-2 variants in wastewater

SARS-CoV-2 remains one of the biggest global health problems, which has already reached our wastewater through fecal shedding by COVID-19 patients. While the development of vaccines has mitigated the threats of the COVID-19 pandemic, the evolutionary dynamics of SARS-CoV-2 in wastewater lack monitoring and understanding. In this study, SARS-CoV-2 variants in wastewater were identified by analyzing 8511 wastewater-derived genome sequences from 9 countries from March 2020 to May 2023. The dominance of co-circulating variants was observed, namely B.1 in 2020, Alpha and Delta in 2021, then superseded by Omicron lineages in 2022 with a three-times increase. Mutations were also profiled, revealing nearly 5031 unique amino acid substitutions occurring approximately 371,591 times, some of which were associated with enhanced viral transmission and fitness. This study provided the first long-term multi-country overview of the prevalence of co-circulating SARS-CoV-2 lineages and mutations in wastewater and showed its comparison with conventional epidemiological surveillance. The results highlight the ability of wastewater-based genome monitoring to supplement clinical surveillance efforts in rapidly detecting viruses up to the strain level to keep track of their potential transmission routes and evolutionary dynamics.