ABSTRACT
In March 2020, we observed an outbreak of COVID-19 among a relatively homogenous group of 199 young (median age 21 years; 87% men) Swiss recruits. By comparing physical endurance before and in median 45 days after the outbreak, we found a significant decrease in predicted maximal aerobic capacity in COVID-19 convalescent but not in asymptomatically infected and SARS-CoV-2 naive recruits. This finding might be indicative of lung injury after apparently mild COVID-19 in young adults.
Subject(s)
Coronavirus Infections/diagnosis , Coronavirus/isolation & purification , Exercise/physiology , Lung Injury/etiology , Oxygen Consumption , Physical Endurance/physiology , Pneumonia, Viral/diagnosis , Pulmonary Ventilation/physiology , Adult , Asymptomatic Infections , Betacoronavirus , COVID-19 , Convalescence , Coronavirus/genetics , Coronavirus Infections/epidemiology , Disease Outbreaks , Female , Humans , Male , Military Personnel , Pandemics , Physical Endurance/immunology , Physical Fitness , Pneumonia, Viral/epidemiology , Reverse Transcriptase Polymerase Chain Reaction , Risk Factors , SARS-CoV-2 , Switzerland/epidemiology , Young AdultABSTRACT
BACKGROUND: Social distancing and stringent hygiene seem to be effective in reducing the number of transmitted virus particles, and therefore the infectivity, of coronavirus disease 2019 (COVID-19) and could alter the mode of transmission of the disease. However, it is not known if such practices can change the clinical course in infected individuals. METHODS: We prospectively studied an outbreak of COVID-19 in Switzerland among a population of 508 predominantly male soldiers with a median age of 21 years. We followed the number of infections in 2 spatially separated cohorts with almost identical baseline characteristics with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) before and after implementation of stringent social distancing. RESULTS: Of the 354 soldiers infected prior to the implementation of social distancing, 30% fell ill from COVID-19, while no soldier in a group of 154, in which infections appeared after implementation of social distancing, developed COVID-19 despite the detection of viral RNA in the nasal and virus-specific antibodies within this group. CONCLUSIONS: Social distancing not only can slow the spread of SARS-CoV-2 in a cohort of young, healthy adults but it can also prevent the outbreak of COVID-19 while still inducing an immune response and colonizing nasal passages. Viral inoculum during infection or mode of transmission may be a key factor determining the clinical course of COVID-19.