Social Distancing Alters the Clinical Course of COVID-19 in Young Adults: A Comparative Cohort Study
Social Distancing Alters the Clinical Course of COVID-19 in Young Adults: A Comparative Cohort Study
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DOI：
10.1093/cid/ciaa889
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发表时间：
2021-02-15
影响因子：
11.8
通讯作者：
Deuel, Jeremy Werner
中科院分区：
文献类型：
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作者：
Bielecki, Michel;Zust, Roland;Deuel, Jeremy Werner
背景社交距离和严格的卫生措施似乎能有效减少2019冠状病毒病（COVID-19）传播的病毒颗粒数量，从而降低其传染性，并可能改变疾病的传播模式。然而，尚不清楚这些做法是否可以改变感染个体的临床病程。我们前瞻性地研究了瑞士爆发的COVID-19，研究对象为508名男性士兵，中位年龄为21岁。我们追踪了在实施严格社交距离之前和之后两个空间上分离的队列中感染严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的人数，这些队列具有几乎相同的基线特征。在实施社交距离之前感染的354名士兵中，30%因COVID-19而患病，而在实施社交距离之后出现感染的154名士兵中，尽管在该群体中检测到鼻内病毒RNA和病毒特异性抗体，但没有一名士兵发展为COVID-19。社交距离不仅可以减缓SARS-CoV-2在年轻健康成年人群体中的传播，还可以预防COVID-19的爆发，同时仍然诱导免疫反应并在鼻腔中定植。感染期间的病毒接种或传播方式可能是决定COVID-19临床病程的关键因素。
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.