Your browser doesn't support javascript.
Risk Factors Associated With COVID-19 Transmission Among US Air Force Trainees in a Congregant Setting.
Marcus, Joseph E; Frankel, Dianne N; Pawlak, Mary T; Casey, Theresa M; Cybulski, Robert J; Enriquez, Erin; Okulicz, Jason F; Yun, Heather C.
  • Marcus JE; Infectious Diseases Service, Brooke Army Medical Center, Joint Base San Antonio, Texas.
  • Frankel DN; Trainee Health Surveillance, 559th Medical Group, Joint Base San Antonio-Lackland, Texas.
  • Pawlak MT; Trainee Health Surveillance, 559th Medical Group, Joint Base San Antonio-Lackland, Texas.
  • Casey TM; Trainee Health Surveillance, 559th Medical Group, Joint Base San Antonio-Lackland, Texas.
  • Cybulski RJ; Clinical Microbiology, Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, Joint Base San Antonio, Texas.
  • Enriquez E; Trainee Health Surveillance, 559th Medical Group, Joint Base San Antonio-Lackland, Texas.
  • Okulicz JF; Infectious Diseases Service, Brooke Army Medical Center, Joint Base San Antonio, Texas.
  • Yun HC; Infectious Diseases Service, Brooke Army Medical Center, Joint Base San Antonio, Texas.
JAMA Netw Open ; 4(2): e210202, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1858185
ABSTRACT
Importance Owing to concerns of coronavirus disease 2019 (COVID-19) outbreaks, many congregant settings are forced to close when cases are detected because there are few data on the risk of different markers of transmission within groups.

Objective:

To determine whether symptoms and laboratory results on the first day of COVID-19 diagnosis are associated with development of a case cluster in a congregant setting. Design, Setting, and

Participants:

This cohort study of trainees with COVID-19 from May 11 through August 24, 2020, was conducted at Joint Base San Antonio-Lackland, the primary site of entry for enlistment in the US Air Force. Symptoms and duration, known contacts, and cycle threshold for trainees diagnosed by reverse transcription-polymerase chain reaction were collected. A cycle threshold value represents the number of nucleic acid amplification cycles that occur before a specimen containing the target material generates a signal greater than the predetermined threshold that defines positivity. Cohorts with 5 or more individuals with COVID-19 infection were defined as clusters. Participants included 10 613 trainees divided into 263 parallel cohorts of 30 to 50 people arriving weekly for 7 weeks of training. Exposures All trainees were quarantined for 14 days on arrival. Testing was performed on arrival, on day 14, and anytime during training when indicated. Protective measures included universal masking, physical distancing, and rapid isolation of trainees with COVID-19. Main Outcomes and

Measures:

Association between days of symptoms, specific symptoms, number of symptoms, or cycle threshold values of individuals diagnosed with COVID-19 via reverse transcription-polymerase chain reaction and subsequent transmission within cohorts.

Results:

In this cohort study of 10 613 US Air Force basic trainees in 263 cohorts, 403 trainees (3%) received a diagnosis of COVID-19 in 129 cohorts (49%). Among trainees with COVID-19 infection, 318 (79%) were men, and the median (interquartile range [IQR]) age was 20 (19-23) years; 204 (51%) were symptomatic, and 199 (49%) were asymptomatic. Median (IQR) cycle threshold values were lower in symptomatic trainees compared with asymptomatic trainees (21.2 [18.4-27.60] vs 34.8 [29.3-37.4]; P < .001). Cohorts with clusters of individuals with COVID-19 infection were predominantly men (204 cohorts [89%] vs 114 cohorts [64%]; P < .001), had more symptomatic trainees (146 cohorts [64%] vs 53 cohorts [30%]; P < .001), and had more median (IQR) symptoms per patient (3 [2-5] vs 1 [1-2]; P < .001) compared with cohorts without clusters. Within cohorts, subsequent development of clusters of 5 or more individuals with COVID-19 infection compared with those that did not develop clusters was associated with cohorts that had more symptomatic trainees (31 of 58 trainees [53%] vs 43 of 151 trainees [28%]; P = .001) and lower median (IQR) cycle threshold values (22.3 [18.4-27.3] vs 35.3 [26.5-37.8]; P < .001). Conclusions and Relevance In this cohort study of US Air Force trainees living in a congregant setting during the COVID-19 pandemic, higher numbers of symptoms and lower cycle threshold values were associated with subsequent development of clusters of individuals with COVID-19 infection. These values may be useful if validated in future studies.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Nucleic Acid Testing / COVID-19 / Military Personnel Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Male / Young adult Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Nucleic Acid Testing / COVID-19 / Military Personnel Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Female / Humans / Male / Young adult Country/Region as subject: North America Language: English Journal: JAMA Netw Open Year: 2021 Document Type: Article