Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Center for Medical Education, Case Western Reserve University School of Medicine, Cleveland, Ohio.
JAMA Netw Open. 2023 Feb 1;6(2):e2255496. doi: 10.1001/jamanetworkopen.2022.55496.
The COVID-19 pandemic affects many diseases, including alcohol use disorders (AUDs). As the pandemic evolves, understanding the association of a new diagnosis of AUD with COVID-19 over time is required to mitigate negative consequences.
To examine the association of COVID-19 infection with new diagnosis of AUD over time from January 2020 through January 2022.
DESIGN, SETTING, AND PARTICIPANTS: In this retrospective cohort study of electronic health records of US patients 12 years of age or older, new diagnoses of AUD were compared between patients with COVID-19 and patients with other respiratory infections who had never had COVID-19 by 3-month intervals from January 20, 2020, through January 27, 2022.
SARS-CoV-2 infection or non-SARS-CoV-2 respiratory infection.
New diagnoses of AUD were compared in COVID-19 and propensity score-matched control cohorts by hazard ratios (HRs) and 95% CIs from either 14 days to 3 months or 3 to 6 months after the index event.
This study comprised 1 201 082 patients with COVID-19 (56.9% female patients; 65.7% White; mean [SD] age at index, 46.2 [18.9] years) and 1 620 100 patients with other respiratory infections who had never had COVID-19 (60.4% female patients; 71.1% White; mean [SD] age at index, 44.5 [20.6] years). There was a significantly increased risk of a new diagnosis of AUD in the 3 months after COVID-19 was contracted during the first 3 months of the pandemic (block 1) compared with control cohorts (HR, 2.53 [95% CI, 1.82-3.51]), but the risk decreased to nonsignificance in the next 3 time blocks (April 2020 to January 2021). The risk for AUD diagnosis increased after infection in January to April 2021 (HR, 1.30 [95% CI, 1.08-1.56]) and April to July 2021 (HR, 1.80 [95% CI, 1.47-2.21]). The result became nonsignificant again in blocks 7 and 8 (COVID-19 diagnosis between July 2021 and January 2022). A similar temporal pattern was seen for new diagnosis of AUD 3 to 6 months after infection with COVID-19 vs control index events.
Elevated risk for AUD after COVID-19 infection compared with non-COVID-19 respiratory infections during some time frames may suggest an association of SARS-CoV-2 infection with the pandemic-associated increase in AUD. However, the lack of excess hazard in most time blocks makes it likely that the circumstances surrounding the pandemic and the fear and anxiety they created also were important factors associated with new diagnoses of AUD.
COVID-19 大流行影响了许多疾病，包括酒精使用障碍（AUD）。随着大流行的发展，需要了解在 COVID-19 期间新诊断出的 AUD 与 COVID-19 的关联随时间的变化，以减轻其带来的负面影响。
从 2020 年 1 月至 2022 年 1 月，检查 COVID-19 感染与 AUD 新诊断之间随时间的关联。
设计、地点和参与者：在这项针对美国 12 岁及以上患者电子健康记录的回顾性队列研究中，比较了 COVID-19 患者与从未感染过 COVID-19 的其他呼吸道感染患者的新 AUD 诊断，时间间隔为从 2020 年 1 月 20 日至 2022 年 1 月 27 日的每 3 个月。
SARS-CoV-2 感染或非 SARS-CoV-2 呼吸道感染。
通过风险比（HR）和 95%置信区间（CI），比较 COVID-19 和倾向评分匹配对照组队列中 COVID-19 或非 COVID-19 呼吸道感染后 14 天至 3 个月或 3 至 6 个月的 AUD 新诊断。
这项研究共纳入了 1201082 例 COVID-19 患者（56.9%为女性患者；65.7%为白人；指数事件时的平均[SD]年龄为 46.2[18.9]岁）和 1620100 例从未感染过 COVID-19 的其他呼吸道感染患者（60.4%为女性患者；71.1%为白人；指数事件时的平均[SD]年龄为 44.5[20.6]岁）。与对照组队列相比，在大流行的前 3 个月中首次出现 COVID-19 感染后的 3 个月内，AUD 新诊断的风险显著增加（HR，2.53[95%CI，1.82-3.51]），但在接下来的 3 个时间块中，风险降至无统计学意义（2020 年 4 月至 2021 年 1 月）。2021 年 1 月至 4 月和 4 月至 7 月感染后，AUD 诊断的风险增加（HR，1.30[95%CI，1.08-1.56]和 1.80[95%CI，1.47-2.21]）。在 2021 年 7 月至 2022 年 1 月的第 7 和第 8 个时间块中，该结果再次变得无统计学意义。COVID-19 感染后 3 至 6 个月 AUD 新诊断的时间模式也类似。
与非 COVID-19 呼吸道感染相比，COVID-19 感染后 AUD 的风险增加，在某些时间段可能表明 SARS-CoV-2 感染与大流行期间 AUD 增加有关。然而，在大多数时间块中没有多余的危害，这使得与大流行相关的情况以及它们所带来的恐惧和焦虑也可能是与 AUD 新诊断相关的重要因素。
