Assessment of Sars-Cov-2 Infection through Rapid Serology Testing in the Homeless Population in the City of Rome, Italy. Preliminary Results

Abstract

Background: The development of COVID-19 pandemic has affected all segments of the population; however, it had a significant impact on vulnerable subjects, such as in people experiencing homelessness. The aim of this study was to evaluate the prevalence of COVID-19 spread in homeless persons in the city of Rome, Italy. Design and Methods: Patients included in the study underwent a clinical evaluation and rapid antibody analysis on capillary blood for the presence of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to SARS-CoV-2 virus. Symptomatic patients were not included in the screening and immediately referred to local hospitals for further evaluation.Results: One-hundred seventy-three patients of both sexes were tested for SARS-CoV-2 infection through rapid serological test. Age range was 8-80 years; people came from 35 different countries of origin and 4 continents. Test results were negative for most patients (170-98.2%); two patients had positive IgM (1.2%) and one patient had positive IgG (0.6%).Conclusions: Our study is the first to evaluate the prevalence of SARS-CoV-2 infection in people experiencing homelessness in the city of Rome, Italy. Most patients were negative for COVID-19, although several factors may have had an impact on this result, such as the exclusion of symptomatic patients, the limited sensitivity of rapid serological tests in the initial stage of infection and the prevention measures adopted in these populations. Larger studies on fragile populations are needed to prevent and intercept new clusters of infection in the upcoming months.

A Scoping Review of the Health Impact of the COVID-19 Pandemic on Persons Experiencing Homelessness in North America and Europe

“…A number of included studies reported infection attack rates of SARS-CoV-2 among study participants: 29 studies measured positivity rates (i.e., current infection) [ 13 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ], seven measured seroprevalence (i.e., prevalence of antibodies for SARS-CoV-2, indicating historic infection) [ 61 , 62 , 63 , 64 , 65 , 66 , 67 ], and four measured both positivity and seroprevalence rates [ 68 , 69 , 70 , 71 ]. Additionally, data regarding SARS-CoV-2 symptoms reported by study participants were provided by 32 articles [ 7 , 8 , 33 , 34 , 35 , 36 , 38 , 42 , 45 , 46 , …”

SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

“…19 quantitative studies were conducted in the USA [23À41], three in Canada [42À44],three in France [16,45,46], two in Italy [47,48], and one in Belgium [49], Spain [50], Slovakia [51], and Denmark [52], respectively. The data collection period considering all studies ranged from January 2020 to October 2020.…”

“…In terms of IPC strategies, 11 studies [29,31,35,37,39,42,47,48,54,56,57] discussed comprehensive and rapid testing including collaboration with regional laboratories for quick turnaround of positive tests, expansion of non-congregate housing and individual strategies in the shelters, e.g. spacing between beds and limited staff rotation, as critical measures to be taken.…”

“…Additionally, while most studies tested PEH in homeless shelters, one study by Yoon et al [35] conducted additional testing of clients living unsheltered during homeless outreach service events (e.g. Seven articles [24,31,35,36,39,47,48,52] provided data specifically for PEH testing positive: specific symptoms (cough, shortness of breath, fever) were either uncommon or did not differ significantly from the overall tested population of PEH. Neither did comorbidities [39].…”

Equal Incidence of COVID-19 among Homeless and Non-Homeless Emergency Department Patients

“…During the pandemic, the primary healthcare services of the [ blinded ], Vatican City, offered a SARS-CoV-2 infection control service for persons experiencing homelessness through nasopharyngeal swab tests and prevention measures [ 2 , 3 ]. Tests were performed in all homeless patients presenting to these facilities seeking general medical care over a period of 16 months.…”