@article{072f8bc46e9f4773ae0db86e0aa044cb,
title = "COVID-19 patients with documented alcohol use disorder or alcohol-related complications are more likely to be hospitalized and have higher all-cause mortality",
abstract = "Background: Coronavirus Disease 2019 (COVID-19) has affected every country globally, with hundreds of millions of people infected with the SARS-CoV-2 virus and over 6 million deaths to date. It is unknown how alcohol use disorder (AUD) affects the severity and mortality of COVID-19. AUD is known to increase the severity and mortality of bacterial pneumonia and the risk of developing acute respiratory distress syndrome. Our objective is to determine whether individuals with AUD have increased severity and mortality from COVID-19. Methods: We utilized a retrospective cohort study of inpatients and outpatients from 44 centers participating in the National COVID Cohort Collaborative. All were adult COVID-19 patients with and without documented AUDs. Results: We identified 25,583 COVID-19 patients with an AUD and 1,309,445 without. In unadjusted comparisons, those with AUD had higher odds of hospitalization (odds ratio [OR] 2.00, 95% confidence interval [CI] 1.94 to 2.06, p < 0.001). After adjustment for age, sex, race/ethnicity, smoking, body mass index, and comorbidities, individuals with an AUD still had higher odds of requiring hospitalization (adjusted OR [aOR] 1.51, CI 1.46 to 1.56, p < 0.001). In unadjusted comparisons, individuals with AUD had higher odds of all-cause mortality (OR 2.18, CI 2.05 to 2.31, p < 0.001). After adjustment as above, individuals with an AUD still had higher odds of all-cause mortality (aOR 1.55, CI 1.46 to 1.65, p < 0.001). Conclusion: This work suggests that AUD can increase the severity and mortality of COVID-19 infection. This reinforces the need for clinicians to obtain an accurate alcohol history from patients hospitalized with COVID-19. For this study, our results are limited by an inability to quantify the daily drinking habits of the participants. Studies are needed to determine the mechanisms by which AUD increases the severity and mortality of COVID-19.",
keywords = "ARDS, EtOH, SARS-CoV-2, alcoholic, smoking, viral pneumonia",
author = "Bailey, {Kristina L.} and Harlan Sayles and James Campbell and Neha Khalid and Madyson Anglim and Jana Ponce and Wyatt, {Todd A.} and McClay, {James C.} and Burnham, {Ellen L.} and Alfred Anzalone and Corrine Hanson",
note = "Funding Information: The project described was supported by the National Institute of General Medical Sciences, U54 GM104942. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Other support for this project was provided by the NIAAA (R25 AA020818 to KLB and R24 AA019661 to ELB, TAW, and KLB) and the Department of Veterans Affairs (I01 CX001714 to CLH). Todd Wyatt is supported by a Research Career Scientist award from the Department of Veterans Affairs (IK6 BX003781). The analyses described in this publication were conducted with data or tools accessed through the NCATS N3C Data Enclave (https://COVID-19.cd2h.org) and N3C Attribution & Publication Policy v 1.2-2020-08-25b supported by NCATS U24 TR002306. This research was possible because of the patients whose information is included within the data and the organizations (https://ncats.nih.gov/n3c/resources/data-contribution/data-transfer-agreement-signatories) and scientists who have contributed to the ongoing development of this community resource [https://doi.org/10.1093/jamia/ocaa196]. Alfred Jerrod Anzalone was supported by grants U54GM104942-05S2 and U54GM115458 from the National Institute of General Medical Sciences, which funds the West Virginia Clinical & Translational Science Institute and the Great Plains IDeA Clinical & Translational Research Network. Funding Information: The project described was supported by the National Institute of General Medical Sciences, U54 GM104942. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Other support for this project was provided by the NIAAA (R25 AA020818 to KLB and R24 AA019661 to ELB, TAW, and KLB) and the Department of Veterans Affairs (I01 CX001714 to CLH). Todd Wyatt is supported by a Research Career Scientist award from the Department of Veterans Affairs (IK6 BX003781). Publisher Copyright: {\textcopyright} 2022 The Authors. Alcoholism: Clinical & Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcoholism.",
year = "2022",
month = jun,
doi = "10.1111/acer.14838",
language = "English (US)",
volume = "46",
pages = "1023--1035",
journal = "Alcoholism: Clinical and Experimental Research",
issn = "0145-6008",
publisher = "Wiley-Blackwell",
number = "6",
}