Department of Emergency Medicine, University of Louisville (UofL), United States of America.
Department of Emergency Medicine, University of Louisville (UofL), United States of America.
Am J Emerg Med. 2022 Mar;53:286.e5-286.e7. doi: 10.1016/j.ajem.2021.09.057. Epub 2021 Sep 25.
The World Health Organization (WHO) declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a pandemic in March 2020. Theoretically, homeless patients could have disproportionately worse outcomes from COVID-19, but little research has corroborated this claim. This study aimed to examine the demographics and incidence of COVID-19 in homeless vs non-homeless emergency department (ED) patients.
This is a retrospective study of all patients seen in the University of Louisville Hospital Emergency Department (ULH ED) from March 2019 to December 2020, excluding January and February 2020. Data was collected from the Kentucky Homeless Management Information System (HMIS) and ULH electronic health records.
A total of 51,532 unique patients had 87,869 visits during the study period. There was a 18.1% decrease in homeless patient visits over the time period, which was similar to the decrease in non-homeless patient visits (19.2%). In the total population, 9471 individuals had known COVID-19 testing results, with a total of 610 positive (6.4% positivity rate). Of the 712 homeless ED patients, 39 tested positive (5.5% positivity rate). After adjusting for age, gender identity, race, and insurance, there was no statistically significant difference in test positivity between homeless and non-homeless patients, OR 1.23 (0.88, 1.73). Homeless patients were less likely to be admitted to either the intensive care unit (ICU) or hospital (OR = 0.55, 95% CI: OR 0.51, 0.60) as they were more likely to be discharged (OR = 1.65, 95% CI: 1.52, 1.79).
Previous literature has indicated that higher disease burden, lack of access to social distancing, and poor hygiene would increase the risk of homeless individuals contracting COVID-19 and experiencing serious morbidity. However, this study found that homelessness was not an independent risk factor for COVID-19 infection.
世界卫生组织（WHO）于 2020 年 3 月宣布严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）为大流行。理论上，无家可归者可能会因 COVID-19 而遭受不成比例的更严重后果，但很少有研究证实这一说法。本研究旨在检查无家可归者和非无家可归者急诊科（ED）患者 COVID-19 的人口统计学和发病率。
这是一项对 2019 年 3 月至 2020 年 12 月在路易斯维尔大学医院急诊科（ULH ED）就诊的所有患者的回顾性研究，不包括 2020 年 1 月和 2 月的数据。数据来自肯塔基州无家可归者管理信息系统（HMIS）和 ULH 电子健康记录。
在研究期间，共有 51532 名患者有 87869 次就诊，无家可归者就诊人数在此期间下降了 18.1%，与非无家可归者就诊人数的下降幅度相似（19.2%）。在总人群中，9471 人有已知的 COVID-19 检测结果，其中 610 人检测结果为阳性（阳性率为 6.4%）。在 712 名无家可归的 ED 患者中，有 39 人检测结果为阳性（阳性率为 5.5%）。在校正年龄、性别认同、种族和保险后，无家可归者和非无家可归者的检测阳性率无统计学差异，OR 为 1.23（0.88，1.73）。无家可归者入住重症监护病房（ICU）或住院的可能性较低（OR=0.55，95%CI：OR 0.51，0.60），而他们更有可能出院（OR=1.65，95%CI：1.52，1.79）。
先前的文献表明，更高的疾病负担、缺乏社交距离以及卫生条件差会增加无家可归者感染 COVID-19 和出现严重疾病的风险。然而，本研究发现，无家可归并不是 COVID-19 感染的独立危险因素。
