A multidisciplinary team of U.S. Navy Medicine personnel published a comprehensive analysis of the spring 2020 USS Theodore Roosevelt SARS-CoV-2 outbreak in the New England Journal of Medicine Nov. 11.

While preliminary findings from a limited population were released in June, along with a report in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, this paper provides an epidemiological description of the outbreak that includes all the crew.

The paper contributes to the growing body of knowledge on the behavior of the new coronavirus and will support continued efforts to stem the impact of the virus in the Navy, in the United States and around the world.

Over the course of the outbreak, 1,271 sailors (27 percent of the crew) tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by rRT-PCR testing. The authors found that working in confined spaces, enlisted rank, history of angiotensin converting enzyme inhibitor use, respiratory disease, and obese body mass index were associated with an increased risk of infection.

In their conclusions, the authors noted SARS-CoV-2 spread quickly among the USS Theodore Roosevelt’s crew. Transmission was facilitated by close quarters and asymptomatic and pre-symptomatically infected crewmembers. Nearly half of those who tested positive for the virus never developed symptoms. These findings show that young, healthy working-age adults can play a role in the spread of SARS-CoV-2.

“We must continue to be aggressive about studying COVID-19 and SARS-CoV-2,” said co-author of the paper, Lt. Cmdr. Matthew Kasper.  “It’s about keeping our operational forces ready and underway, protecting the health of our personnel, while contributing to the general body of knowledge of this virus.”

The New England Journal of Medicine article can be found here: https://www.nejm.org/doi/full/10.1056/NEJMoa2019375?query=featured_home