Journal Article

Association of Alcohol Use with COVID-19 Infection and Hospitalization Among People Living with HIV in the United States, 2020

Chander, Geetanjali, Shapiro, Adrienne E, Jacobson, Jeffrey M, Saag, Michael, Lau, Bryan, Delaney, Joseph A, Mayer, Kenneth H, Crane, Heidi M, Napravnik, Sonia, Puryear, Sarah, Hutton, Heidi E, Xia, Chunyi, Lesko, Catherine R, McCaul, Mary E, Cachay, Edward R

2024

Overview

Alcohol use was associated with elevated COVID-19 risk in the general population. People with HIV (PWH) have high prevalences of alcohol use. To evaluate the effect of alcohol use on COVID-19 risks among PWH, we estimated the risk of COVID-19 diagnosis and COVID-19-related hospitalization among PWH in routine care at 8 HIV primary care centers that contributed data to the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort according to their alcohol use just prior to the COVID-19 pandemic. The CNICS data repository includes demographic characteristics, clinical diagnoses, and laboratory test results from electronic medical records and other sources. Alcohol use, substance use, and mental health symptoms were self-reported on tablet-based standardized surveys. Alcohol use was categorized according to standard, sex-specific Alcohol Use Disorder Identification Test-Consumption instrument cut-offs. We followed 5,496 PWH (79% male, 48% Black race, median age = 53 years) from March 1, 2020 to December 31, 2020. Relative to PWH with no baseline alcohol use, the adjusted hazard ratio (aHR) of COVID-19 diagnosis was 1.09 (95% confidence interval [CI]: 0.78, 1.51) for lower-risk drinking and 1.19 (95%CI: 0.81, 1.73) for unhealthy drinking. The aHR of COVID-19-related hospitalization was 0.82 (95%CI: 0.33, 1.99) for lower-risk drinking and 1.25 (95%CI: 0.50, 3.09) for unhealthy drinking. Results were not modified by recent cocaine or non-prescribed opioid use, depressive symptoms, or diagnoses of alcohol use disorder. The study suggested a slightly increased, but not statistically significant risk of COVID-19 diagnosis and hospitalization associated with unhealthy alcohol use.

• Publisher: Springer Nature B.V
• Subject: Acquired immune deficiency syndrome / AIDS / Alcohol use / Alcoholism / Alcohols / Clinical research / Cocaine / Computerized medical records / COVID-19 / Demography / Diagnosis / Drinking / Drinking behavior / Electronic health records / Electronic medical records / HIV / Hospitalization / Human immunodeficiency virus / Information technology / Laboratory tests / Medical diagnosis / Medical records / Mental depression / Mental disorders / Mental health / Opioids / Pandemics / Primary care / Race / Risk / Sexually transmitted diseases / Statistical analysis / STD / Substance abuse / Substance use / Substance use disorder / Symptoms