Charité Center for Global Health, Institute of International Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Berliner Stadtmission, Berlin, Germany.
Front Public Health. 2023 Jun 6;11:1147558. doi: 10.3389/fpubh.2023.1147558. eCollection 2023.
People experiencing homelessness (PEH) are disproportionately affected by the COVID-19 pandemic. For many PEH it is impossible to isolate due to the lack of permanent housing. Therefore, an isolation facility for SARS-CoV-2 positive PEH was opened in Berlin, Germany, in May 2020, offering medical care, opioid and alcohol substitution therapy and social services. This study aimed to assess the needs of the admitted patients and requirements of the facility.
This was a retrospective patient record study carried out in the isolation facility for PEH in Berlin, from December 2020 to June 2021. We extracted demographic and clinical data including observed psychological distress from records of all PEH tested positive for SARS-CoV-2 by RT-PCR. Data on duration and completion of isolation and the use of the facilities' services were analyzed. The association of patients' characteristics with the completion of isolation was assessed by Student's -test or Fisher's exact test.
A total of 139 patients were included in the study (89% male, mean age 45 years, 41% with comorbidities, 41% non-German speakers). 81% of patients were symptomatic (median duration 5 days, range 1-26). The median length of stay at the facility was 14 days (range 2-41). Among the patients, 80% had non-COVID-19 related medical conditions, 46% required alcohol substitution and 17% opioid substitution therapy. Three patients were hospitalized due to low oxygen saturation. No deaths occurred. Psychological distress was observed in 20%, and social support services were used by 65% of PEH. The majority (82%) completed the required isolation period according to the health authority's order. We did not observe a statistically significant association between completion of the isolation period and sociodemographic characteristics.
The specialized facility allowed PEH a high compliance with completion of the isolation period. Medical care, opioid and alcohol substitution, psychological care, language mediation and social support are essential components to address the specific needs of PEH. Besides contributing to infection prevention and control, isolation facilities may allow better access to medical care for SARS-CoV-2 infected PEH with possibly positive effects on the disease course.
无家可归者（PEH）受到 COVID-19 大流行的不成比例影响。对于许多无家可归者来说，由于缺乏永久住所，因此无法隔离。因此，2020 年 5 月在德国柏林开设了一个针对 SARS-CoV-2 阳性无家可归者的隔离设施，提供医疗保健、阿片类药物和酒精替代治疗以及社会服务。本研究旨在评估入住患者的需求和设施的要求。
这是一项在柏林的无家可归者隔离设施中进行的回顾性患者病历研究，时间为 2020 年 12 月至 2021 年 6 月。我们从所有通过 RT-PCR 检测出 SARS-CoV-2 呈阳性的无家可归者的记录中提取了人口统计学和临床数据，包括观察到的心理困扰。分析了隔离时间和完成情况以及设施服务的使用情况。通过 Student's -test 或 Fisher's exact test 评估患者特征与隔离完成的相关性。
共纳入 139 名患者（89%为男性，平均年龄 45 岁，41%有合并症，41%非德语使用者）。81%的患者有症状（中位数持续时间 5 天，范围 1-26 天）。设施的中位停留时间为 14 天（范围 2-41 天）。在患者中，80%有非 COVID-19 相关的医疗状况，46%需要酒精替代治疗，17%需要阿片类药物替代治疗。由于低氧饱和度，有 3 名患者住院。无死亡病例发生。20%的患者出现心理困扰，65%的无家可归者使用社会支持服务。根据卫生当局的命令，大多数（82%）患者完成了规定的隔离期。我们没有观察到隔离期完成与社会人口统计学特征之间存在统计学显著关联。
专门设施允许无家可归者高度遵守完成隔离期的规定。医疗保健、阿片类药物和酒精替代、心理护理、语言调解和社会支持是满足无家可归者特定需求的重要组成部分。除了有助于感染预防和控制外，隔离设施还可能使感染 SARS-CoV-2 的无家可归者更好地获得医疗保健，可能对疾病进程产生积极影响。
