Israel Defense Forces, Medical Corps, Ramat Gan 02149, Israel.
Department of Military Medicine, Hebrew University, Jerusalem 9112102, Israel.
Mil Med. 2023 May 16;188(5-6):e1293-e1299. doi: 10.1093/milmed/usab451.
To assess the clinical features and infectivity of variant B.1.1.7 among healthy young adults in a military setting.
Positive cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a single military base (March 23, 2020 and February 16, 2021) were included. An epidemiological investigation conducted via phone included questions regarding symptoms, exposure history, smoking status, list of contacts, and recently visited places. Symptoms surveyed included fever, cough, shortness of breath, sore throat, loss of smell or taste, gastrointestinal symptoms (GI), headache, chest pain, and constitutional symptoms. Cases were divided before B.1.1.7 first reported case in Israel (December 23, 2020) (period 1) and after its identification (period 2). Symptom distribution and the risk of a contact to be infected were compared between the periods, using a chi-square test, and a negative binominal regression model, respectively.
Of 293 confirmed cases, 89 were reported in the first period and 204 in the second. 56.0% were men with a median age of 19.5 years (interquartile range 18.6-20.5). GI symptoms, loss of taste or smell, headache, fever, and chills were more prevalent in the first period (P < .001, P = .026, P = .034, P = .001, and P < .001, respectively), while fatigue was more common in the second period (P = .008). The risk of a contact to be infected was three times higher in the second period (relative risk = 3.562 [2.414-5.258]).
An outbreak of SARS-CoV-2 in young healthy adults, during a period with high national-wide B.1.1.7 variant prevalence, is characterized by decreased prevalence of fever, loss of taste or smell and GI symptoms, increased reports of fatigue, and more infected contacts for each index case.
评估变异株 B.1.1.7 在军事环境中健康年轻成年人中的临床特征和传染性。
纳入了一个军事基地内(2020 年 3 月 23 日至 2021 年 2 月 16 日)单一严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)阳性病例。通过电话进行的流行病学调查包括症状、暴露史、吸烟状况、接触者名单和最近去过的地方等问题。调查的症状包括发热、咳嗽、呼吸急促、喉咙痛、嗅觉或味觉丧失、胃肠道症状(GI)、头痛、胸痛和全身症状。病例分为在以色列首次报告变异株 B.1.1.7 病例之前(2020 年 12 月 23 日)(第 1 期)和之后(第 2 期)。使用卡方检验和负二项回归模型分别比较两个时期的症状分布和接触者感染风险。
在 293 例确诊病例中,第 1 期报告了 89 例,第 2 期报告了 204 例。56.0%为男性,中位年龄为 19.5 岁(四分位距 18.6-20.5)。第 1 期胃肠道症状、味觉或嗅觉丧失、头痛、发热和寒战更为常见(P<0.001、P=0.026、P=0.034、P<0.001 和 P<0.001),而第 2 期疲劳更为常见(P=0.008)。第 2 期接触者感染的风险是第 1 期的三倍(相对风险 3.562[2.414-5.258])。
在全国范围内 B.1.1.7 变异株高流行期间,SARS-CoV-2 在年轻健康成年人中的爆发,其特征是发热、味觉或嗅觉丧失和胃肠道症状的流行率降低,疲劳报告增加,每个病例的感染接触者更多。