Factors Associated with SARS-CoV2 Infection and Care Pathways Among the Most Vulnerable Populations Living in Marseille: A Case Control Study

Abstract

Background: Mainland France has been seriously affected by the Covid-19 epidemic, which has brought significant and unexpected morbidity and mortality. Precarious people cared for in accommodation centers are particularly at risk of infection because of collective housing, their dependence on the support system and therefore their difficulty in applying barrier measures. These populations are also subject to a risk of more severe infections or a delay in seeking treatment. This study aims to identify the factors associated with SARS-CoV2 infection in the most vulnerable populations in Marseille.Methods: The sample on which the study was carried out consists of association users, whether or not presenting a symptomatology suggestive of Covid-19, and routinely treated between March 2020 and May 2020. Through univariate and multivariate analyzes, we studied the influence of several variables on morbidity attributable to SARS-CoV2. Results: 64 participants were enrolled in the study with 29 cases and 35 control subject. Median age was 21.16 years old with a younger age in the case group (p < 0.005). Sex ratio was 7. Risk factors of SARS-CoV2 in multivariate analysis were living in a shared apartment and a low compliance for distancing measure. Participants presented frequent mental health problems such as anxiety. Conclusions: The allocation of housing to structures involved with the most precarious people appears to be a decisive factor in the fight against the spread of SARS-CoV2 and therefore deserves more attention from public authorities.