Paired wastewater and clinical genomics across metropolitan and hospital catchments reveals SARS-CoV-2 relevant mutations
By integrating wastewater and clinical genomics across metropolitan and hospital catchments in Valencia, this study demonstrates that while wastewater surveillance effectively tracks dominant SARS-CoV-2 lineages and can detect emerging mutations like S:V445P missed by clinical sampling, its ability to capture fine-scale diversity and hospitalization-linked mutations varies by location, necessitating integration with large-scale clinical GWAS and interaction networks to prioritize evolutionarily significant variants.