Seroprevalence and risk factors of exposure to COVID-19 in homeless people in Paris, France: a cross-sectional study.
Seroprevalence and risk factors of exposure to COVID-19 in homeless people in Paris, France: a cross-sectional study.
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DOI：
10.1016/s2468-2667(21)00001-3
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发表时间：
2021-04
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影响因子：
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通讯作者：
Luquero FJ
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作者：
Roederer T;Mollo B;Vincent C;Nikolay B;Llosa AE;Nesbitt R;Vanhomwegen J;Rose T;Goyard S;Anna F;Torre C;Fourrey E;Simons E;Hennequin W;Mills C;Luquero FJ
在2020年3月17日至5月11日的新冠肺炎封锁期间，法国巴黎及其郊区当局将反复无家可归的人重新安置到紧急避难所、酒店和大型场馆。在其中一些地点进行了血清学调查，以评估这一群体中新冠肺炎的暴露流行率。我们在巴黎的无国界医生组织和法兰西岛地区的塞纳圣丹尼提供医疗服务的食品分发地点、紧急避难所和工人住所进行了横断面血清阳性率研究。用荧光素酶联免疫吸附试验和假性中和试验检测SARS冠状病毒2型抗体阳性。通过口头问卷收集与社会人口学和暴露相关的信息，以分析危险因素及其与各种新冠肺炎症状的关系。在2020年6月23日至7月2日期间，在14个地点招募的818人中，有426人(52%)检测呈阳性。不同招募地点的血清阳性率有显著差异(χ2 P<；0·0001)，最高的是工人住宅区(88·7%，95%CI 81·8-93·2)，其次是紧急避难所(50·5%，46·3-54·7)和食品配送点(27·8%，20·8-35·7)。超过三分之二的新冠肺炎血清阳性者(68%，95%可信区间·2-72.2%；426人中有291人)在召回期间没有报告任何症状。新冠肺炎阳性与过度拥挤密切相关(中密度：调整后优势比[AOR]2·7，95%可信区间1·5~5·1，p=0.0020；高密度：调整后优势比3·4，1·7~6·9，p<；0.0001)。这些结果表明，SARS-CoV-2在不同研究地点的暴露程度很高，有重要的差异。居住在拥挤的环境中是与暴露水平相关的最强因素。这项研究强调了提供安全、不拥挤的住宿以及足够的检测和公共卫生信息的重要性。无国界医生，震中，巴斯德研究所的紧急新冠状病毒基金，道达尔基金会。
During the COVID-19 lockdown period from March 17 to May 11, 2020, French authorities in Paris and its suburbs relocated people experiencing recurrent homelessness to emergency shelters, hotels, and large venues. A serological survey was done at some of these locations to assess the COVID-19 exposure prevalence in this group. We did a cross-sectional seroprevalence study at food distribution sites, emergency shelters, and workers' residences that were provided medical services by Médecins Sans Frontières in Paris and Seine-Saint-Denis in the Ile-de-France region. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody seropositivity was detected by Luciferase-Linked Immunosorbent Assay and Pseudo Neutralization Test. Sociodemographic and exposure related information was collected via a verbal questionnaire to analyse risk factors and associations with various COVID-19 symptoms. Between June 23 and July 2, 2020, 426 (52%) of 818 individuals recruited tested positive in 14 sites. Seroprevalence varied significantly by type of recruitment site (χ2 p<0·0001), being highest among those living in workers' residences (88·7%, 95% CI 81·8–93·2), followed by emergency shelters (50·5%, 46·3–54·7), and food distribution sites (27·8%, 20·8–35·7). More than two thirds of COVID-19 seropositive individuals (68%, 95% CI 64·2–72·2; 291 of 426) did not report any symptoms during the recall period. COVID-19 seropositivity was strongly associated with overcrowding (medium density: adjusted odds ratio [aOR] 2·7, 95% CI 1·5–5·1, p=0·0020; high density: aOR 3·4, 1·7–6·9, p<0·0001). These results show high exposure to SARS-CoV-2 with important variations between those at different study sites. Living in crowded conditions was the strongest factor associated with exposure level. This study underscores the importance of providing safe, uncrowded accommodation, alongside adequate testing and public health information. Médecins Sans Frontières, Epicentre, Institut Pasteur's URGENCE nouveau coronavirus fund, Total Foundation.