Antiviral drugs have been used to treat the ever-growing number of coronavirus disease 2019 (COVID-19) patients. Consequently, unprecedented amounts of such drug residues discharging into ambient waters raise concerns on the potential ecotoxicological effects to aquatic lives, as well as development of antiviral drug-resistance in wildlife. Here, we estimated the occurrence, fate and ecotoxicological risk of 11 therapeutic agents suggested as drugs for COVID-19 treatment and their 13 metabolites in wastewater and environmental waters, based on drug consumption, physical-chemical property using quantitative structure-activity relationship (QSAR), and ecotoxicological and pharmacological data for the drugs. Our results suggest that the removal efficiencies at conventional wastewater treatment plants will remain low (< 20%) for half of the substances, and consequently, high drug residues (e.g. 7402 ng/L ribavirin, 4231 ng/L favipiravir, 730 ng/L lopinavir, 319 ng/L remdesivir; each combined for both unchanged forms and metabolites; and when each drug is administered to 100 patients out of 100,000 populations on a day) can be present in secondary effluents and persist in the environmental waters. Ecotoxicological risk in receiving river waters can be high (risk quotient > 1) by a use of favipiravir, lopinavir, umifenovir and ritonavir, and medium (risk quotient > 0.1) by a use of chloroquine, hydroxychloroquine, remdesivir, and ribavirin, while the risk will remain small (risk quotient < 0.1) for dexamethasone and oseltamivir. The potential of wild animals acquiring antiviral drug resistance is estimated to be small. Our prediction suggests a pressing need for proper usage and waste management of antiviral drugs as well as for improving removal efficiencies of drug residues in wastewater.
• Phylogeny of the SARS-CoV-2 is remarkably similar to SARS of pangolin and/or bat origin. • Transmission depends on respiratory droplet size, environmental condition and immunity. • COVID-19 progression is highly debated for temperature, humidity, and lifestyle dependence. • Infection can be restricted through restricting binding of S protein and AE2. • Increasing neutrophil and lymphocyte ratio (NLR) may give early sign of COVID-19.
Recently reported detection of SARS-CoV-2 in wastewater around the world has led to emerging concerns on potential risk in water bodies receiving treated wastewater effluent. This review aims to provide an up-to-date state of key knowledge on the impact of SARS-CoV-2 in natural water bodies receiving treated wastewater. In this review, SARS-CoV-2 concentrations in wastewater, expected removal in WWTPs, and possible dilution and decay in water bodies are reviewed based on past studies on SARS-CoV-2 and related enveloped viruses. We suggest a quantitative microbial risk assessment (QMRA) framework to estimate the potential risk of SARS-CoV-2 in natural water bodies through various water activities. Dose–response model of SARS-CoV and Poisson’s distribution is employed to estimate possible viral ingestion and the annual chance of infection through several water activities in natural water bodies. Finally, future perspectives and research needs have been addressed to overcome the limitations and uncertainty in the risk assessment of SARS-CoV-2 in natural water bodies.
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