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SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: Systematic review and meta-analysis

Universität Bielefeld; Ludwig-Maximilians-Universität München

The research team has summarized studies that examined the risk of transmission and the consequences of Corona for homeless people.

  • Disziplin: Gesundheit, Weitere
  • Forschungsmethode: Quantitativ
  • Forschungsdesign: Sekundäranalyse, Weitere Daten (z. B. Einzelinterview, Web Scraping, Laborwerte etc.)
  • Erhebungsstatus: Erhebung abgeschlossen, Ergebnisse veröffentlicht, Daten zugänglich

Ziele der Studie

People experiencing homelessness (PEH) are at increased risk of infectious, chronic, and mental health adverse conditions. Due to the risk of transmission in shared accommodations, PEH may be particularly vulnerable to SARS-Cov-2 infection and worse clinical outcomes. Non-pharmaceutical interventions (NPIs) taken to mitigate the SARS-Cov-2 outbreak may have further aggravated health and social conditions. However, there is no evidence synthesis on the SARS-Cov-2 epidemiology among PEH, the correspondent clinical and other health-related outcomes as well as health effects of NPIs on these groups.

Therefore, the researchers aimed to synthesize the evidence on the risk of infection and transmission, risk of severe course of disease, effect of non-pharmaceutical interventions (NPI) on health outcomes and IPC strategies to avert risks and negative outcomes among PEH.

The systematic review was guided by five specific research questions:

  1. What is the prevalence or incidence of infection with SARS-CoV-2 in homeless shelters?
  2. What is the evidence on transmission among PEH in different settings (e. g. in homeless shelters, at outreach events, when sleeping rough on the street)?
  3. What are clinical and other health-related outcomes of the disease among PEH (e. g. measured by hospitalisation, ICU, ventilation, mortality)?
  4. What is the evidence on the effects of lockdown measures and other non-pharmacological interventions on the health status of PEH?
  5. What is the evidence on the effects of policies/strategies specifically enacted for PEH?


The team developed and registered a review protocol in PROSPERO (PROSPERO registration 2020 CRD42020187033), and followed the recommendations of the taskforce on guidelines for systematic reviews in health promotion and public health. To answer these questions, they conducted a systematic search of scientific databases for peer-reviewed articles in EMBASE, the WHO Covid19 database, and Web of Science Core Collection, the Norwegian Institute of Public Health’s live map of COVID-19 evidence, websites of relevant institutions and two not-indexed journals, including reference snowballing.


Detailed review lists can be provided by the corresponding author upon reasonable request.