• Elena Crouch, Joseph E Marcus, Heather C Yun, Teresa M Casey, John Kieffer, Erin Winkler, Angela B Osuna, Korey Kasper, James Aden, and John L Kiley.
• Department of Medicine, Brooke Army Medical Center, San Antonio, TX 78234, USA.
• Mil Med. 2024 Dec 5.

IntroductionThe impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on physical fitness in previously healthy adults is not well understood. In this study, we assess the impact of SARS-CoV-2 infection on the physical fitness test (PT) scores of Air Force basic trainees.Materials And MethodsSARS-CoV-2 testing data and trainee fitness test scores for the calendar year 2021 were obtained from U.S. Air Force basic military trainees. Trainees perform a standardized fitness test including push-ups, sit-ups, and a 2.4 kilometer run at the beginning and end of their training. For this study, basic trainees who performed 2 fitness tests in 2021 and also tested positive for SARS-CoV-2 were defined as the infected cohort. These were 1:1 matched by sex to an uninfected control group of basic trainees. Changes in fitness test scores and pass-fail rates were then compared across the infected and control groups.ResultsA total of 23,450 basic trainees performed a PT in calendar year 2021, 975 (4%) of whom tested positive for SARS-CoV-2. A total of 621 (64%) had completed 2 fitness tests during the defined study period and were included in the infected cohort. There were 96 females (15.5%) in each group and 525 males (84.5%) in each group. There was no difference in body mass index between the infected and the control groups (24.0 [Interquartile range (IQR) 21.8 to 36.0] vs. 24.3 [IQR 21.7-36.9], P = .253). The infected group had a higher rate of failing their PT at the end of training when compared to control (15.7% vs. 4.3%, P < .001). When comparing those who passed their first fitness test and went on to fail their second fitness test, this occurred more frequently in the infected group (2.3% vs. 0.81%, P = .037). When comparing trainees who failed their first fitness test and went on to pass their second fitness test, this occurred more frequently in the control group (46.3% vs. 39.6%, P = .016). Among the infected group, there were no differences in second test failure rates when comparing symptomatic to asymptomatic trainees (16.9% vs. 11.8%, P = .143).ConclusionsSARS-CoV-2 infection was associated with an increased risk of PT failure as well as conversion from a passing to failing test score. There were no differences in second test failure rates in symptomatic compared to asymptomatic trainees. A key confounder to the data was the effect deconditioning had on fitness during isolation.© The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.

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