Serological and RT-PCR Surveillance for COVID-19 in an Asymptomatic US Army Trainee Population

Shilpa Hakre; Aaron D Sanborn; Stephen W Krauss; Jennifer L Burns; Kenya N Jackson; Melanie D McCauley; Brittany L Ober Shepherd; Samantha McHenry; Shauna L Stahlman; Elizabeth J Bianchi; Joanna Freeman; Jason Ouellette; Jeremiah Stubbs; Crystal Brigantti; Tara L Hall; Milford H Beagle Jr; Paul O Kwon; Jason A Pieri; Timothy R Frambes; Clinton K Murray; Steven B Cersovsky; Kayvon Modjarrad; Sheila A Peel; Paul T Scott

doi:10.1093/ofid/ofab407

Serological and RT-PCR Surveillance for COVID-19 in an Asymptomatic US Army Trainee Population

Open Forum Infect Dis. 2021 Jul 29;8(9):ofab407. doi: 10.1093/ofid/ofab407. eCollection 2021 Sep.

Authors

Shilpa Hakre^{1

2}, Aaron D Sanborn³, Stephen W Krauss⁴, Jennifer L Burns⁵, Kenya N Jackson⁶, Melanie D McCauley^{1

2}, Brittany L Ober Shepherd^{1

2}, Samantha McHenry², Shauna L Stahlman⁷, Elizabeth J Bianchi^{1

2}, Joanna Freeman^{2

5}, Jason Ouellette^{2

5}, Jeremiah Stubbs⁸, Crystal Brigantti⁸, Tara L Hall⁸, Milford H Beagle Jr⁹, Paul O Kwon⁸, Jason A Pieri⁹, Timothy R Frambes⁹, Clinton K Murray¹⁰, Steven B Cersovsky¹¹, Kayvon Modjarrad¹, Sheila A Peel⁵, Paul T Scott¹

Affiliations

¹ Emerging Infectious Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
² Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA.
³ Clinical Trials Center, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
⁴ Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
⁵ Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
⁶ Experimental Therapeutics, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
⁷ Armed Forces Health Surveillance Division, Silver Spring, Maryland, USA.
⁸ Moncrief Army Health Clinic, Fort Jackson, South Carolina, USA.
⁹ United States Army Training Center, Fort Jackson, South Carolina, USA.
¹⁰ Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
¹¹ US Army Public Health Center, Aberdeen Proving Ground, Maryland, USA.

Abstract

Background: Significant variability exists in the application of infection control policy throughout the US Army initial entry training environment. To generate actionable information for the prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19) transmission among new recruits, active enhanced surveillance was conducted for evidence of and exposure to SARS-CoV-2/COVID-19.

Methods: We serially tested recruits with a reverse transcriptase polymerase chain reaction (RT-PCR) COVID-19 and/or total antibody to SARS-CoV-2 tests at days 0, 14, and week 10 upon arrival for basic combat training at a location in the Southern United States.

Results: Among 1403 recruits who were enrolled over a 6-week period from August 25 through October 11, 2020, 84 recruits tested positive by RT-PCR, with more than half (55%, 46/84) testing positive at arrival and almost two-thirds (63%, 53/84) also testing seropositive at arrival. Similarly, among an overall 146 recruits who tested seropositive for SARS-CoV-2 during the period of observation, a majority (86%) tested seropositive at arrival; no hospitalizations were observed among seropositive recruits, and antibody response increased at week 10.

Conclusions: These findings that suggest serological testing may complement current test-based measures and provide another tool to incorporate in COVID-19 mitigation measures among trainees in the US Army.

Keywords: Army; COVID-19; asymptomatic; recruit; serology.