Dataset Information

SARS-CoV-2 antibody prevalence among homeless people and shelter workers in Denmark: a nationwide cross-sectional study.

ABSTRACT:

Background

People experiencing homelessness (PEH) and associated shelter workers may be at higher risk of infection with "Severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). The aim of this study was to determine the prevalence of SARS-CoV-2 among PEH and shelter workers in Denmark.

Design and methods

In November 2020, we conducted a nationwide cross-sectional seroprevalence study among PEH and shelter workers at 21 recruitment sites in Denmark. The assessment included a point-of-care test for antibodies against SARS-CoV-2, followed by a questionnaire. The seroprevalence was compared to that of geographically matched blood donors considered as a proxy for the background population, tested using a total Ig ELISA assay.

Results

We included 827 participants in the study, of whom 819 provided their SARS-CoV-2 antibody results. Of those, 628 were PEH (median age 50.8 (IQR 40.9-59.1) years, 35.5% female) and 191 were shelter workers (median age 46.6 (IQR 36.1-55.0) years and 74.5% female). The overall seroprevalence was 6.7% and was similar among PEH and shelter workers (6.8% vs 6.3%, p = 0.87); and 12.2% among all participants who engaged in sex work. The overall participant seroprevalence was significantly higher than that of the background population (2.9%, p < 0.001). When combining all participants who reported sex work or were recruited at designated safe havens, we found a significantly increased risk of seropositivity compared to other participants (OR 2.23, 95%CI 1.06-4.43, p = 0.02). Seropositive and seronegative participants reported a similar presence of at least one SARS-CoV-2 associated symptom (49% and 54%, respectively).

Interpretations

The prevalence of SARS-CoV-2 antibodies was more than twice as high among PEH and associated shelter workers, compared to the background population. These results could be taken into consideration when deciding in which phase PEH are eligible for a vaccine, as part of the Danish national SARS-CoV-2 vaccination program rollout.

Funding

TrygFonden and HelseFonden.

SUBMITTER: Eriksen ARR

PROVIDER: S-EPMC9238223 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND:Population-based data on COVID-19 are essential for guiding policies. There are few such studies, particularly from low or middle-income countries. Brazil is currently a hotspot for COVID-19 globally. We aimed to investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody prevalence by city and according to sex, age, ethnicity group, and socioeconomic status, and compare seroprevalence estimates with official statistics on deaths and cases. METHODS:In this repeated cross-sectional study, we did two seroprevalence surveys in 133 sentinel cities in all Brazilian states. We randomly selected households and randomly selected one individual from all household members. We excluded children younger than 1 year. Presence of antibodies against SARS-CoV-2 was assessed using a lateral flow point-of-care test, the WONDFO SARS-CoV-2 Antibody Test (Wondfo Biotech, Guangzhou, China), using two drops of blood from finger prick samples. This lateral-flow assay detects IgG and IgM isotypes that are specific to the SARS-CoV-2 receptor binding domain of the spike protein. Participants also answered short questionnaires on sociodemographic information (sex, age, education, ethnicity, household size, and household assets) and compliance with physical distancing measures. FINDINGS:We included 25?025 participants in the first survey (May 14-21) and 31?165 in the second (June 4-7). For the 83 (62%) cities with sample sizes of more than 200 participants in both surveys, the pooled seroprevalence increased from 1·9% (95% CI 1·7-2·1) to 3·1% (2·8-3·4). City-level prevalence ranged from 0% to 25·4% in both surveys. 11 (69%) of 16 cities with prevalence above 2·0% in the first survey were located in a stretch along a 2000 km of the Amazon river in the northern region. In the second survey, we found 34 cities with prevalence above 2·0%, which included the same 11 Amazon cities plus 14 from the northeast region, where prevalence was increasing rapidly. Prevalence levels were lower in the south and centre-west, and intermediate in the southeast, where the highest level was found in Rio de Janeiro (7·5% [4·2-12·2]). In the second survey, prevalence was similar in men and women, but an increased prevalence was observed in participants aged 20-59 years and those living in crowded conditions (4·4% [3·5-5·6] for those living with households with six or more people). Prevalence among Indigenous people was 6·4% (4·1-9·4) compared with 1·4% (1·2-1·7) among White people. Prevalence in the poorest socioeconomic quintile was 3·7% (3·2-4·3) compared with 1·7% (1·4-2·2) in the wealthiest quintile. INTERPRETATION:Antibody prevalence was highly heterogeneous by country region, with rapid initial escalation in Brazil's north and northeast. Prevalence is strongly associated with Indigenous ancestry and low socioeconomic status. These population subgroups are unlikely to be protected if the policy response to the pandemic by the national government continues to downplay scientific evidence. FUNDING:Brazilian Ministry of Health, Instituto Serrapilheira, Brazilian Collective Health Association, and the JBS Fazer o Bem Faz Bem.

Project description:BackgroundThe SARS-CoV-2 virus responsible for severe respiratory infection associated with coronavirus disease 2019 (COVID-19) was first confirmed in Florida on March 1, 2020. Responding to the pandemic, multi-agency collaborative partnerships put in place actions integrating point-of-care antibody testing at established large-scale COVID-19 testing sites where the baseline seropositivity of COVID-19 in health care workers and first responders in Florida at the start of the pandemic was established.PurposeDetermine the seropositivity of healthcare workers and first responders at five drive thru testing sites using a rapid SARS-CoV-2 antibody test in Florida from May 6 through June 3, 2020.MethodsThe first drive-thru SARS-CoV-2 antibody test site was opened at Miami Hard Rock Stadium, May 6, 2020. Testing expanded to three additional sites on May 9, 2020: Jacksonville, Orlando, and Palm Beach. The fifth and final site, Miami Beach, began testing on May 21, 2020. Healthcare workers and first responder's self-seeking SARS-CoV-2 testing were designated for antibody testing and completed a laboratory collection form onsite for the point-of-care test. All testing was performed on whole blood specimens (obtained by venipuncture) using the Cellex Inc. qSARS-CoV-2 IgG/IgM Rapid Test. Seropositivity was assessed by univariate analysis and by logistic regression including the covariates age, sex, race/ethnicity, and testing location.Results and discussionAs of June 3, 2020, of 5,779 healthcare workers and first responders tested, 4.1% were seropositive (range 2.6-8.2%). SARS-COV-2 antibody tests had higher odds of being positive for persons testing at the Miami Hard Rock Stadium (aOR 2.24 [95% C.I. 1.48-3.39]), persons of Haitian/Creole ethnicity (aOR 3.28 [95% C.I. 1.23-8.72]), Hispanic/Latino(a) ethnicity (aOR 2.17 [95% C.I. 1.50-3.13], and Black non-Hispanic persons (aOR 1.63 [95% C.I. 1.08-2.46]). SARS-COV-2 antibody prevalence among first responders and healthcare workers in five sites in Florida varied by race and ethnicity and by testing location.

Project description:Nasal colonization of methicillin-resistant Staphylococcus aureus (MRSA) plays an important role in the epidemiology and pathogenesis of disease. Situations of close-quarter contact in groups are generally regarded as a risk factor for community-acquired MRSA strains due to transmission via fomites and person-to-person contact. With these criteria for risk, homeless individuals using shelter facilities, including showers and toilets, should be considered high risk for colonization and infection. The aim of this study was to determine the prevalence of nasal colonization of MRSA in a homeless population compared to established rates of colonization within the public and a control group of subjects from a neighboring medical school campus, and to analyze phylogenetic diversity among the MRSA strains. Nasal samples were taken from the study population of 332 adult participants and analyzed. In addition, participants were surveyed about various lifestyle factors in order to elucidate potential patterns of behavior associated with MRSA colonization. Homeless and control groups both had higher prevalence of MRSA (9.8 and 10.6%, respectively), when compared to the general population reported by previous studies (1.8%). However, the control group had a similar MRSA rate compared to health-care workers (4.6%), while the homeless population had an increased prevalence. Risk factors identified in this study included male gender, age over 50?years, and use of antibiotics within the past 3?months. Phylogenetic relationships between nine of the positive samples from the homeless population were analyzed, showing eight of the nine samples had a high degree of relatedness between the spaA genes of the MRSA strains. This indicates that the same MRSA strain might be transmitted from person-to-person among homeless population. These findings increase our understanding of key differences in MRSA characteristics within homeless populations, as well as risks for MRSA associated with being homeless, such as age and gender, which may then be a useful tool in guiding more effective prevention, treatment, and health care for homeless individuals.