{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T03:41:43Z","timestamp":1762054903535,"version":"build-2065373602"},"reference-count":91,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T00:00:00Z","timestamp":1655337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Militaries worldwide have been affected by COVID-19 pandemic. However, the impact and epidemiological characteristics of transmission during the early phase of the pandemic is not well-studied. This study aims to systematically estimate the baseline incidence of COVID-19 in the military worldwide and identify the potential risk factors of transmission and clinical characteristics of the cases. English and Chinese literature reporting COVID-19 cases in military worldwide published on four electronic databases (PubMed, Scopus, EMBASE, and CKNI) through 28 May 2021 were systematically screened and synthesized qualitatively. Forty-six studies involving at least 711,408 military personnel in 17 countries were synthesized. Low incidence of cases was observed in the military with pooled COVID-19 incidence of 0.19% (95%CI: 0.00\u20139.18%). We observed a higher incidence among those (1) with overseas exposure (39.85%; 95%CI: 0.00\u201395.87%) rather than local exposure (3.03%; 95%CI: 0.00\u201312.53%), (2) who were on either local\/overseas military deployment (26.78%; 95%CI: 0.00\u201371.51%) as compared to those not deployed (4.37%; 95%CI: 0.00\u201317.93%), and (3) on overseas military deployment (39.84%; 95%CI: 0.00\u201395.87%) as compared to local military deployment (3.03%; 95%CI: 2.37\u20133.74%). The majority of the cases were symptomatic (77.90% (95%CI: 43.91\u2013100.00%)); hospitalization and mortality rates were low at 4.43% (95%CI: 0.00\u201325.34%) and 0.25% (95%CI: 0.00\u20130.85%), respectively; and headache, anosmia, ageusia, myalgia, nasal congestion, and cough were the most commonly observed symptoms. Overseas and local deployment were observed to have higher risk of SARS-CoV-2 transmission. Sustainable, active SARS-CoV-2 surveillance strategies are crucial to detect and contain transmission early during military deployments.<\/jats:p>","DOI":"10.3390\/ijerph19127418","type":"journal-article","created":{"date-parts":[[2022,6,17]],"date-time":"2022-06-17T01:48:12Z","timestamp":1655430492000},"page":"7418","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["SARS-CoV-2 Transmission in the Military during the Early Phase of the Pandemic\u2014A Systematic Analysis"],"prefix":"10.3390","volume":"19","author":[{"given":"Sylvia Xiao Wei","family":"Gwee","sequence":"first","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore"},{"name":"Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pearleen Ee Yong","family":"Chua","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore"},{"name":"Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9788-701X","authenticated-orcid":false,"given":"Junxiong","family":"Pang","sequence":"additional","affiliation":[{"name":"Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore"},{"name":"Centre for Infectious Disease Epidemiology and Research, National University of Singapore, Singapore 117549, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, June 25). 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