Case series of coronavirus (SARS-CoV-2) in a military recruit school: clinical, sanitary and logistical implications
Case series of coronavirus (SARS-CoV-2) in a military recruit school: clinical, sanitary and logistical implications
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DOI：
10.1136/bmjmilitary-2020-001482
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发表时间：
2021-08-01
影响因子：
1.5
通讯作者：
Morand, G. B.
中科院分区：
文献类型：
--
作者：
Baettig, Sascha J.;Parini, A.;Morand, G. B.
2019年底，一种名为“严重急性呼吸综合征-冠状病毒-2”（SARS-CoV-2）的新型冠状病毒在中国出现，目前已引起全球大流行。到目前为止，还没有在军事环境中描述COVID-19的影响。因此，我们报告了瑞士一所新兵学校感染患者的一系列病例以及与此相关的挑战。方法回顾性分析瑞士最南端提契诺州SARS-CoV-2大流行初期瑞士军队新兵COVID-19病例。鼻咽拭子两次PCR检测SARS-CoV-2阳性，确定阳性病例。血清学检测采用市售试剂盒，按照制造商说明进行。结果第一例病例可能是在周末许可期间滑雪时感染的。4天后，他出现症状，SARS-CoV-2检测呈阳性，并被隔离。48小时后症状完全消失。连队140名新兵中，有55人在两天内与新冠病毒有过密切接触，已被隔离。在一个特定的隔离室里，九名新兵中有七名出现了轻微症状。其中一人SARS-CoV-2 PCR阳性。在初步诊断后7天，该患者和另一名隔离患者的SARS-CoV-2再次检测呈阳性，尽管他们已经完全无症状超过96小时。血清学检测结果均为阳性。其余均为IgM、IgG阴性。结论年轻健康新兵新冠肺炎病程轻，症状下降快，但持续为SARS-CoV-2携带者。这说明了无症状患者如何可能负责隐蔽的病毒传播。尽早和长期地对患者和密切接触者实施隔离和检疫，对于减缓SARS-CoV-2的传播至关重要，特别是在军事环境的密闭空间中。
Introduction A new coronavirus, called Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2), has emerged from China in late 2019 and has now caused a worldwide pandemic. The impact of COVID-19 has not been described so far in a military setting. We therefore report a case series of infected patients in a recruit school in Switzerland and the herein associated challenges. Methods Retrospective review of COVID-19 cases among Swiss Armed Forces recruits in the early weeks of SARS-CoV-2 pandemic in the canton of Ticino, the southernmost canton of Switzerland. Positive cases were defined with two positive PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Serological testing was performed with a commercially available kit according to manufacturers' instructions. Results The first case was likely contaminated while skiing during weekend permission. He became symptomatic 4 days later, tested positive for SARS-CoV-2 and was put into isolation. He showed complete symptom resolution after 48 hours. Quarantine was ordered for all recruits with close contact in the past 2 days, a total of 55 persons out of 140 in the company. Seven out of nine recruits in one particular quarantine room became mildly symptomatic. SARS-CoV-2 PCR was positive in one of them. Seven days after initial diagnosis, the index patient and the other one from the quarantine retested positive for SARS-CoV-2, although they had been completely asymptomatic for over 96 hours. Serological testing revealed positive for both patients. All others showed negative IgM and IgG. Conclusions Young healthy recruits often showed a mild course of COVID-19 with rapid symptom decline but were persistent SARS-CoV-2 carriers. This illustrates how asymptomatic patients may be responsible for covert viral transmission. An early and prolonged establishment of isolation and quarantine for patients and close contacts is essential to slow down the spread of SARS-CoV-2, especially in the confined space of a military environment.