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A recent study published in the Canadian Medical Association Journal (CMAJ) has revealed that individuals experiencing homelessness (PEH) who were hospitalized with acute COVID-19 symptoms did not experience higher in-hospital death rates or hospital admission rates compared to housed individuals.
Researchers from the University of British Columbia, led by Dr. Siying Shari Li, an emergency medicine physician, analyzed data from the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). The study encompassed visits to 50 emergency departments across eight Canadian provinces from March 1, 2020, onwards.
The study aimed to determine if homelessness itself was an independent risk factor for worse COVID-19 outcomes, after accounting for other critical factors such as age, pre-existing health conditions, vaccination status, and substance use. PEH were identified as individuals “having no fixed address” or arriving from a shelter, while housed individuals arrived from their homes or single-occupancy residences. The study excluded residents of institutions, visitors, and those arriving from hotels.
The researchers found no statistically significant difference in hospital admission rates or in-hospital death rates between the two groups. However, PEH were less likely to be admitted to the intensive care unit (ICU) or to require intubation.
“In our study, we sought to answer the question of whether experiencing homelessness is a risk factor for worse prognosis from COVID-19 illness independent of important clinical variables… i.e., whether clinicians should have a lower threshold for admission or other treatments for patients with COVID-19 based on housing status alone,” Dr. Li stated.
The researchers raised concerns about the lower ICU admission and intubation rates among PEH, suggesting potential disparities in treatment. “[This] raises the question of whether there may have been differential treatment for reasons unrelated to matched clinical characteristics. Future research could explore inequities in health care resource allocation, especially in times of scarcity, as well as interventions targeting transmission among PEH,” the researchers concluded.
The findings challenge assumptions about the vulnerability of PEH to worse COVID-19 outcomes in hospital settings, while also highlighting the need for further investigation into potential inequities in healthcare delivery.
Disclaimer: This article is based on a single study and should not be interpreted as definitive medical advice. Further research is necessary to fully understand the impact of homelessness on COVID-19 outcomes. Healthcare decisions should always be made in consultation with a qualified medical professional. The study suggests a lack of difference in death and admission rates, but raises questions about ICU admittance and intubation rates, and does not address the overall risk of contracting COVID-19 in the homeless population.
