Investigating Unhealthy Alcohol Use As an Independent Risk Factor for Increased COVID-19 Disease Severity: Observational Cross-sectional Study
| Autor: | Connor McCluskey, Niranjan S. Karnik, Yousaf Ilyas, Robert A. Balk, Dale L. Smith, Randy A. Boley, Majid Afshar, Ali Keshavarzian, Sameer Bhalla, Brihat Sharma |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Cross-sectional study substance use Health Informatics Disease mechanical ventilation Severity of Illness Index unhealthy alcohol use Odds Risk Factors Internal medicine Severity of illness medicine Humans Risk factor Uncategorized Original Paper SARS-CoV-2 business.industry substance misuse Public Health Environmental and Occupational Health COVID-19 Odds ratio Emergency department acute respiratory distress syndrome Cross-Sectional Studies Observational study business |
| Zdroj: | JMIR Public Health and Surveillance |
| DOI: | 10.25417/uic.21153211.v1 |
| Popis: | Background Unhealthy alcohol use (UAU) is known to disrupt pulmonary immune mechanisms and increase the risk of acute respiratory distress syndrome in patients with pneumonia; however, little is known about the effects of UAU on outcomes in patients with COVID-19 pneumonia. To our knowledge, this is the first observational cross-sectional study that aims to understand the effect of UAU on the severity of COVID-19. Objective We aim to determine if UAU is associated with more severe clinical presentation and worse health outcomes related to COVID-19 and if socioeconomic status, smoking, age, BMI, race/ethnicity, and pattern of alcohol use modify the risk. Methods In this observational cross-sectional study that took place between January 1, 2020, and December 31, 2020, we ran a digital machine learning classifier on the electronic health record of patients who tested positive for SARS-CoV-2 via nasopharyngeal swab or had two COVID-19 International Classification of Disease, 10th Revision (ICD-10) codes to identify patients with UAU. After controlling for age, sex, ethnicity, BMI, smoking status, insurance status, and presence of ICD-10 codes for cancer, cardiovascular disease, and diabetes, we then performed a multivariable regression to examine the relationship between UAU and COVID-19 severity as measured by hospital care level (ie, emergency department admission, emergency department admission with ventilator, or death). We used a predefined cutoff with optimal sensitivity and specificity on the digital classifier to compare disease severity in patients with and without UAU. Models were adjusted for age, sex, race/ethnicity, BMI, smoking status, and insurance status. Results Each incremental increase in the predicted probability from the digital alcohol classifier was associated with a greater odds risk for more severe COVID-19 disease (odds ratio 1.15, 95% CI 1.10-1.20). We found that patients in the unhealthy alcohol group had a greater odds risk to develop more severe disease (odds ratio 1.89, 95% CI 1.17-3.06), suggesting that UAU was associated with an 89% increase in the odds of being in a higher severity category. Conclusions In patients infected with SARS-CoV-2, UAU is an independent risk factor associated with greater disease severity and/or death. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|