Swanson Garth R, Schwartz Benjamin A, Joyce Cara, Keshavarzian Ali
Center for Integrated Microbiome and Chronobiology Research, Rush University Medical Center, Chicago, Illinois, USA.
Section of Digestive Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.
Alcohol Clin Exp Res (Hoboken). 2023 May;47(5):908-918. doi: 10.1111/acer.15052. Epub 2023 May 28.
Nurses and other first responders are at high risk of exposure to the SARS-CoV2 virus, and many have developed severe COVID-19 infection. A better understanding of the factors that increase the risk of infection after exposure to the virus could help to address this. Although several risk factors such as obesity, diabetes, and hypertension have been associated with an increased risk of infection, many first responders develop severe COVID-19 without established risk factors. As inflammation and cytokine storm are the primary mechanisms in severe COVID-19, other factors that promote an inflammatory state could increase the risk of COVID-19 in exposed individuals. Alcohol misuse and shift work with subsequent misaligned circadian rhythms are known to promote a pro-inflammatory state and thus could increase susceptibility to COVID-19. To test this hypothesis, we conducted a prospective, cross-sectional observational survey-based study in nurses using the American Nursing Association network.
We used validated structured questionnaires to assess alcohol consumption (the Alcohol Use Disorders Identification Test) and circadian typology or chronotype (the Munich Chronotype Questionnaire Shift -MCTQ-Shift).
By latent class analysis (LCA), high-risk features of alcohol misuse were associated with a later chronotype, and binge drinking was greater in night shift workers. The night shift was associated with more than double the odds of COVID-19 infection of the standard shift (OR 2.67, 95% CI: 1.18 to 6.07). Binge drinkers had twice the odds of COVID-19 infection of those with low-risk features by LCA (OR: 2.08, 95% CI: 0.75 to 5.79).
Working night shifts or binge drinking may be risk factors for COVID-19 infection among nurses. Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce.
护士和其他一线急救人员面临感染严重急性呼吸综合征冠状病毒2（SARS-CoV2）的高风险，许多人已感染了严重的2019冠状病毒病（COVID-19）。更好地了解接触该病毒后增加感染风险的因素有助于解决这一问题。尽管肥胖、糖尿病和高血压等几个风险因素与感染风险增加有关，但许多一线急救人员在没有既定风险因素的情况下也患上了严重的COVID-19。由于炎症和细胞因子风暴是严重COVID-19的主要机制，其他促进炎症状态的因素可能会增加接触者感染COVID-19的风险。已知酒精滥用和随后昼夜节律失调的轮班工作会促进炎症状态，因此可能会增加对COVID-19的易感性。为了验证这一假设，我们利用美国护士协会网络对护士进行了一项基于前瞻性横断面观察调查的研究。
我们使用经过验证的结构化问卷来评估酒精摄入量（酒精使用障碍识别测试）和昼夜类型或生物钟类型（慕尼黑生物钟类型问卷轮班版-MCTQ-Shift）。
通过潜在类别分析（LCA），酒精滥用的高风险特征与较晚的生物钟类型相关，并且夜班工作者的暴饮情况更为严重。夜班感染COVID-19的几率是标准班的两倍多（比值比[OR]为2.67，95%置信区间[CI]：1.18至6.07）。根据LCA，暴饮者感染COVID-19的几率是低风险特征者的两倍（OR：2.08，95%CI：0.75至5.79）。
夜班工作或暴饮可能是护士感染COVID-19的风险因素。了解这些风险因素背后的机制有助于减轻COVID-19对处于危险中的医护人员的影响。
