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Symptom Characterization and Outcomes of Sailors in Isolation After a COVID-19 Outbreak on a US Aircraft Carrier

Educational Objective
To understand the symptom characterization and outcomes of sailors in isolation after a COVID-19 outbreak on a US aircraft carrier
1 Credit CME

Reports of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks affecting nursing homes, homeless shelters, and cruise ships describe both asymptomatic and symptomatic cases among patients whose primary risk factor for acquisition was residence in a confined congregate environment.13 However, the age distribution of patients with coronavirus disease 2019 (COVID-19) described is weighted heavily toward elderly individuals and those with preexisting conditions. The USS Theodore Roosevelt (TR) outbreak investigation by the US Navy and Centers for Disease Control and Prevention illuminated how the virus affects a young military population.4 In this study, the US Army Public Health COVID-19 Task Force describes the results of an independent investigation of the shore-based USS TR outbreak response and 736 USS TR sailors in isolation status.

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Article Information

Accepted for Publication: August 4, 2020.

Published: October 1, 2020. doi:10.1001/jamanetworkopen.2020.20981

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Alvarado GR et al. JAMA Network Open.

Corresponding Author: Gadiel R. Alvarado, DO, Infectious Disease Department, Brooke Army Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 (gadiel.r.alvarado.mil@mail.mil).

Author Contributions: Dr Alvarado had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Alvarado, Pierson, Gama, Cole, Jang.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: Alvarado, Pierson, Gama, Jang.

Statistical analysis: Alvarado, Pierson, Gama, Cole, Jang.

Administrative, technical, or material support: Alvarado, Teemer, Gama, Cole, Jang.

Supervision: Alvarado, Jang.

Conflict of Interest Disclosures: None reported.

Disclaimer: The views expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of the Army, the Department of the Air Force, the Department of the Navy, or the Department of Defense or the US Government.

Additional Contributions: Matthew Dolan, MD (Infectious Disease Department, Brooke Army Medical Center, Fort Sam Houston), reviewed the manuscript. He was not compensated for his time.

References
1.
Moriarty  LF , Plucinski  MM , Marston  BJ ,  et al; CDC Cruise Ship Response Team; California Department of Public Health COVID-19 Team; Solano County COVID-19 Team.  Public health responses to COVID-19 outbreaks on cruise ships—worldwide, February-March 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(12):347-352. doi:10.15585/mmwr.mm6912e3PubMedGoogle ScholarCrossref
2.
McMichael  TM , Currie  DW , Clark  S ,  et al; Public Health–Seattle and King County; EvergreenHealth; CDC COVID-19 Investigation Team.  Epidemiology of COVID-19 in a long-term care facility in King County, Washington.   N Engl J Med. 2020;382(21):2005-2011. doi:10.1056/NEJMoa2005412PubMedGoogle ScholarCrossref
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Mosites  E , Parker  EM , Clarke  KEN ,  et al; COVID-19 Homelessness Team.  Assessment of SARS-CoV-2 infection prevalence in homeless shelters—four U.S. cities, March 27-April 15, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(17):521-522. doi:10.15585/mmwr.mm6917e1PubMedGoogle ScholarCrossref
4.
Payne  DC , Smith-Jeffcoat  SE , Nowak  G ,  et al.  SARS-CoV-2 infections and serologic responses from a sample of U.S. Navy service members—USS Theodore Roosevelt, April 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(23):714-721. doi:10.15585/mmwr.mm6923e4PubMedGoogle ScholarCrossref
5.
Chow  EJ , Schwartz  NG , Tobolowsky  FA ,  et al.  Symptom screening at illness onset of health care personnel with SARS-CoV-2 infection in King County, Washington.   JAMA. 2020;323(20):2087-2089. doi:10.1001/jama.2020.6637PubMedGoogle ScholarCrossref
6.
Lechien  JR , Chiesa-Estomba  CM , De Siati  DR ,  et al.  Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study.   Eur Arch Otorhinolaryngol. 2020;277(8):2251-2261. doi:10.1007/s00405-020-05965-1PubMedGoogle ScholarCrossref
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