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SARS-CoV-2 antibody prevalence among homeless people, sex workers and shelter workers in Denmark: a nationwide cross-sectional study [article]

Alexandra R. Roethlin Eriksen, Kamille Fogh, Rasmus Bo Hasselbalch, Henning Bundgaard, Susanne Dam Nielsen, Charlotte Svaerke Joergensen, Bibi FSS Scharff, Christian Erikstrup, Susanne G Saekmose, Dorte K Holm, Bitten Aagaard, Jonas H Kristensen (+23 others)
2021 medRxiv   pre-print

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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
more » ... ntibodies 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% 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). Participants engaging in sex work had a significantly increased risk of seropositivity compared to other participants (95% CI: 0.86-2.36, 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. The subset of the study participants who were also sex workers were at particularly high risk of COVID-19 infection. Funding Tryg and HelseFonden.
doi:10.1101/2021.05.07.21256388 fatcat:cbdvhfh3tjhm3f6sxr7sai2nki
Citation

Alexandra R. Roethlin Eriksen, Kamille Fogh, Rasmus Bo Hasselbalch, Henning Bundgaard, Susanne Dam Nielsen, Charlotte Svaerke Joergensen, Bibi FSS Scharff, Christian Erikstrup, Susanne G Saekmose, Dorte K Holm, Bitten Aagaard, Jonas H Kristensen, Cecilie A Boedker, Jakob B Norsk, Pernille B Nielsen, Lars Oestergaard, Svend Ellermann-Eriksen, Berit Andersen, Henrik Nielsen, Isik S Johansen, Lothar Wiese, Lone Simonsen, Thea K Fischer, Fredrik Folke, Freddy Lippert, Sisse R Ostrowski, Steen Ethelberg, Anders Koch, Anne-Marie Vangsted, Tyra Krause, Anders Fomsgaard, Claus Nielsen, Henrik Ullum, Robert Skov, Kasper K Iversen. "SARS-CoV-2 antibody prevalence among homeless people, sex workers and shelter workers in Denmark: a nationwide cross-sectional study." medRxiv (2021)