Adjusted and unadjusted hazard of outcomes related to COVID-19 (Jan. 23 to July 31, 2020) for people with a recent history of homelessness
| Characteristic | Hazard ratio (95% CI); outcome | ||||
|---|---|---|---|---|---|
| Tested* | Positivity† | Hospital admission‡ | Intensive care§ | Death¶ | |
| Unadjusted analysis | |||||
| People with a recent history of homelessness (Ref. = community-dwelling people) | |||||
| Preshutdown period: Jan. 23 to Mar. 13 | 3.06 (2.33–4.03) | NR | NR | NR | NR |
| Peak period: Mar. 14 to June 16 | 5.06 (4.93–5.19) | 5.07 (4.94–5.20) | 65.12 (53.45–79.34) | 33.75 (20.27–56.18) | 7.64 (4.09–14.24) |
| Reopening period: June 17 to July 31 | 2.39 (2.30–2.49) | 1.05 (1.04–1.07) | 0.51 (0.17–1.59) | NR | NR |
| Adjusted analysis | |||||
| People with a recent history of homelessness (Ref. = community-dwelling people) | |||||
| Preshutdown period: Jan. 23 to Mar. 13 | 1.61 (1.22–2.11) | NR | NR | NR | NR |
| Peak period: Mar. 14 to June 16 | 2.95 (2.88–3.03) | 3.66 (3.22–4.16) | 20.35 (16.23–25.53) | 10.20 (5.81–17.93) | 5.73 (3.01–10.91) |
| Reopening period: June 17 to July 31 | 1.45 (1.39–1.51) | 1.76 (1.15–2.71) | 0.38 (0.12–1.17) | NR | NR |
| Age group, yr (Ref. = youth [18–24 yr]) | |||||
| Young adults (25–39) | 2.02 (2.01–2.03) | 2.05 (1.97–2.13) | 3.47 (2.70–4.46) | 4.39 (2.37–8.14) | 4.99 (0.56–44.53) |
| Older adults (40–64) | 2.03 (2.02–2.04) | 2.18 (2.10–2.26) | 9.84 (7.86–12.31) | 21.67 (12.45–37.73) | 44.24 (6.16–317.75) |
| Seniors (≥ 65) | 1.90 (1.89–1.91) | 1.31 (1.25–1.37) | 17.66 (14.04–22.2) | 28.81 (16.40–50.61) | 321.6 (44.9–2299.9) |
| Sex (Ref. = female) | 0.76 (0.76–0.76) | 0.91 (0.89–0.94) | 1.31 (1.23–1.40) | 1.88 (1.66–2.14) | 1.36 (1.18–1.58) |
| Immigration status** (Ref. = not an immigrant) | 0.87 (0.86–0.87) | 1.83 (1.75–1.90) | 1.41 (1.22–1.63) | 1.64 (1.27–2.11) | 0.93 (0.57–1.51) |
| Income quintile (Ref. = highest income quintile)††‡‡ | |||||
| 1 (lowest income) | 0.96 (0.95–0.96) | 2.01 (1.93–2.09) | 2.02 (1.82–2.25) | 1.93 (1.57–2.36) | 1.64 (1.30–2.08) |
| 2 | 0.95 (0.95–0.96) | 1.52 (1.46–1.58) | 1.38 (1.23–1.55) | 1.48 (1.20–1.83) | 1.22 (0.96–1.56) |
| 3 | 0.94 (0.94–0.95) | 1.42 (1.36–1.48) | 1.33 (1.18–1.49) | 1.27 (1.02–1.58) | 1.24 (0.97–1.58) |
| 4 | 0.94 (0.94–0.95) | 1.18 (1.13–1.23) | 1.19 (1.06–1.34) | 1.34 (1.08–1.67) | 1.00 (0.77–1.30) |
| Urbanicity (Ref. = large CMA [> 500 000 population]) | |||||
| Small to medium-sized urban centres (10 000–500 000 population | 1.13 (1.13–1.14) | 0.48 (0.47–0.50) | 0.44 (0.41–0.48) | 0.45 (0.39–0.53) | 0.51 (0.43–0.61) |
| Areas with < 10 000 population | 1.11 (1.10–1.11) | 0.30 (0.28–0.32) | 0.25 (0.21–0.31) | 0.29 (0.21–0.41) | 0.27 (0.18–0.40) |
| Unknown | 1.11 (1.10–1.13) | 0.68 (0.63–0.74) | 0.41 (0.32–0.54) | 0.50 (0.31–0.81) | 0.20 (0.09–0.45) |
| Comorbidities at baseline (Ref. = no comorbidity) | |||||
| Asthma or COPD | 1.24 (1.24–1.25) | 1.06 (1.03–1.09) | 1.27 (1.18–1.37) | 1.32 (1.15–1.53) | 1.36 (1.17–1.59) |
| Diabetes | 1.02 (1.01–1.03) | 1.38 (1.34–1.43) | 1.78 (1.66–1.92) | 2.22 (1.94–2.54) | 1.68 (1.44–1.95) |
| Congestive heart failure | 1.48 (1.47–1.49) | 1.42 (1.32–1.52) | 1.92 (1.73–2.13) | 1.40 (1.13–1.74) | 2.51 (2.09–3.01) |
| Hypertension | 1.10 (1.10–1.11) | 1.30 (1.26–1.34) | 1.63 (1.50–1.76) | 1.57 (1.36–1.81) | 2.35 (1.91–2.89) |
| No. of outpatient visits in past year | 1.01 (1.01–1.01) | 1.01 (1.01–1.01) | 1.01 (1.01–1.01) | 1.01 (1.01–1.01) | 1.01 (1.01–1.01) |
| Health care for mental health in past year | 1.40 (1.40–1.41) | 1.04 (1.01–1.08) | 1.22 (1.12–1.32) | 0.98 (0.83–1.16) | 1.37 (1.14–1.65) |
Note: CI = confidence interval, CMA = census metropolitan area, COPD = chronic obstructive pulmonary disease, COVID-19 = coronavirus disease 2019, NR = insufficient outcomes in group to report, Ref. = reference category, SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2.
↵* Receipt of at least 1 test for SARS-CoV-2 that was not cancelled or rejected.
↵† Receipt of at least 1 positive test for confirmed SARS-CoV-2 infection.
↵‡ At least 1 hospital admission for confirmed COVID-19 or within 21 d of the first positive SARS-CoV-2 test result.
↵§ At least 1 hospital admission requiring intensive care for confirmed COVID-19 or within 21 d of the first positive SARS-CoV-2 test result.
↵¶ Death within 21 d of the first positive SARS-CoV-2 test result.
↵** Immigration status defined on the basis of the presence of a landing date in the Immigration, Refugees and Citizenship Canada Permanent Resident Database between 2008 and 2018.
↵†† Income quintiles at the Dissemination Area level, derived from census 2016 data.
↵‡‡ Missing and unknown values recoded to quintile 3.