Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Seroprevalence of SARS-CoV-2 Antibodies Among Homeless People Living Rough, in Shelters and Squats: A Large Population-Based Study in France

Version 1 : Received: 28 May 2021 / Approved: 31 May 2021 / Online: 31 May 2021 (12:15:39 CEST)

How to cite: Loubière, S.; Monfardini, E.; Allaria, C.; Mosnier, M.; Allibert, A.; Ninove, L.; Bosetti, T.; Farnarier, C.; Auquier, P.; Mosnier, E.; Tinland, A. Seroprevalence of SARS-CoV-2 Antibodies Among Homeless People Living Rough, in Shelters and Squats: A Large Population-Based Study in France. Preprints 2021, 2021050766 (doi: 10.20944/preprints202105.0766.v1). Loubière, S.; Monfardini, E.; Allaria, C.; Mosnier, M.; Allibert, A.; Ninove, L.; Bosetti, T.; Farnarier, C.; Auquier, P.; Mosnier, E.; Tinland, A. Seroprevalence of SARS-CoV-2 Antibodies Among Homeless People Living Rough, in Shelters and Squats: A Large Population-Based Study in France. Preprints 2021, 2021050766 (doi: 10.20944/preprints202105.0766.v1).

Abstract

Background: Overcrowded housing, as well as inadequate sanitary conditions, contribute to making homeless people particularly vulnerable to the SARS-CoV-2 infection. We aimed to assess the seroprevalence of the SARS-CoV-2 infection among people experiencing homelessness on a large city-wide scale in France, taking into account different community settings. Methods: A consortium of outreach teams in 48 different locations including streets, slums, squats, emergency or transitional shelters and drop-in centres participated in the inclusion process. All participants consented to receive a validated rapid assay for immunoglobulins M (IgM) and G (IgG) antibodies and to answer a questionnaire on medical health conditions, comorbidities, historic of symptoms compatible with COVID-19, with a retrospective calendar of types of accommodation since COVID-19 crisis. Results: From June 01 to August 05, 2020, 1,156 homeless participants were enrolled in the study and tested. Seroprevalence of SARS-CoV-2 IgG/IgM antibodies was 5.6% (95%CI 2.3–7.0), with a range of 2.2% in people living on the streets to 8.1% in people living in emergency shelters (P=0.009). Around one third of the seropositive participants reported symptoms with COVID-19. Compared to the general population in Marseille (3.6%), the homeless population living in the same urban area experienced an significant increased risk of SARS-CoV-2 infection (|z|=3.65 > 1.96). Conclusion: These results highlight the need for organizing regular screening to prevent clusters forming in homeless accommodations and for providing basic resources for health maintenance.

Keywords

Homelessness; SARS-CoV-2; Health inequalities; seroprevalence; Housing conditions

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