COVID-19 related morbidity and mortality in people experiencing homelessness in the Netherlands

People who are homeless might be more at risk for getting infected by the SARS-COV-2 virus or for experiencing severe course of the infection due to their often more fragile health, unmet health needs, and poorer living conditions. This study aims to gain insight into the morbidity and mortality of...

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Bibliographic Details
Published in:	PloS one Vol. 19; no. 2; p. e0296754
Main Authors:	Mennis, Eline, Hobus, Michelle, van den Muijsenbergh, Maria, van Loenen, Tessa
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 05-02-2024 Public Library of Science (PLoS)
Subjects:	Biology and life sciences COVID-19 - epidemiology Earth Sciences Epidemics Family medicine Female Health aspects Homelessness Hospital care Humans Ill-Housed Persons Infection Medical care Medical research Medicine and health sciences Medicine, Experimental Methods Morbidity Needs assessment Netherlands Netherlands - epidemiology Patient outcomes People and Places Physicians Prevention Retrospective Studies SARS-CoV-2 Social aspects Social Sciences Netherlands
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Summary:	People who are homeless might be more at risk for getting infected by the SARS-COV-2 virus or for experiencing severe course of the infection due to their often more fragile health, unmet health needs, and poorer living conditions. This study aims to gain insight into the morbidity and mortality of the SARS-COV-2 virus among the homeless population in the Netherlands. In this observational retrospective study, anonymized data about patients experiencing homelessness who contacted a street doctor were gathered in nine cities in the Netherlands from March 2020 until March 2021. Data included patient characteristics, COVID-19 -related symptoms, diagnosis, and disease course of a SARS-COV-2 infection. Of the total 1419 patients in whom 1544 COVID-19 related consults were registered, 16% tested positive for a SARS-COV-2 infection, and an additional 12% were clinically suspected of having a SARS-COV-2 infection but were seen before there were any COVID-19 tests available in General Practice or for some other reason not tested. Significantly more (p = <0.001) patients born outside the European Union tested positive for a SARS-COV-2 infection (36%) compared to the remainder of the population (20%). The most discerning symptom for being tested positive was loss of taste and smell (29% vs 6% in the negative tested group and 2% in the suspected group), fever (24% vs 13% in the negative tested group but 18% in the suspected group), and headache (26% vs 17% resp 14%), and fatigue (29% vs 20 resp 17%). Cough, dyspnea and common cold were more often seen in the clinically suspected but not tested group). Of the group that tested positive for a SARS-COV-2 infection, 10% were hospitalized. Two patients were admitted to intensive care and one patient died. Of patients who were clinically suspected of a SARS-COV-2 infection, 5% were hospitalized. COVID-19 was not widespread among people experiencing homelessness in the Netherlands, but the number of hospitalizations in this study was relatively high. Monitoring this population during a pandemic is necessary to take prompt action when needed.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 Competing Interests: the authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0296754