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 10-80 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.Significance for public healthThe development of COVID-19 pandemic has affected all segments of the population; however, it had a significant impact on vulnerable subjects, such as the homeless population. People experiencing homelessness live in environments that may favor contagion and infection spread; the presence of the SARS-CoV-2 among them is rarely known, and it is possible to imagine them as hidden sources of contagion that may be difficult to trace through epidemiological link studies. Furthermore, people experiencing homelessness have an all-cause mortality higher than the general population, and COVID-19 might further increase this disparity. A more detailed understanding of the characteristics and spread of SARS-CoV-2 infection among the homeless population is of utmost importance to develop public health interventions in these communities and to prevent and intercept new clusters of infection.