Abstract
Objectives: To evaluate the associations of status, amount, and frequency of alcohol consumption across different alcoholic beverages with coronavirus disease 2019 (COVID-19) risk and associated mortality.Methods: This study included 473,957 subjects, 16,559 of whom tested positive for COVID-19. Multivariate logistic regression analyses were used to evaluate the associations of alcohol consumption with COVID-19 risk and associated mortality. The non-linearity association between the amount of alcohol consumption and COVID-19 risk was evaluated by a generalized additive model.Results: Subjects who consumed alcohol double above the guidelines had a higher risk of COVID-19 (1.12 [1.00, 1.25]). Consumption of red wine above or double above the guidelines played protective effects against the COVID-19. Consumption of beer and cider increased the COVID-19 risk, regardless of the frequency and amount of alcohol intake. Low-frequency of consumption of fortified wine (1–2 glasses/week) within guidelines had a protective effect against the COVID-19. High frequency of consumption of spirits (≥5 glasses/week) within guidelines increased the COVID-19 risk, whereas the high frequency of consumption of white wine and champagne above the guidelines decreased the COVID-19 risk. The generalized additive model showed an increased risk of COVID-19 with a greater number of alcohol consumption. Alcohol drinker status, frequency, amount, and subtypes of alcoholic beverages were not associated with COVID-19 associated mortality.Conclusions: The COVID-19 risk appears to vary across different alcoholic beverage subtypes, frequency, and amount. Red wine, white wine, and champagne have chances to reduce the risk of COVID-19. Consumption of beer and cider and spirits and heavy drinking are not recommended during the epidemics. Public health guidance should focus on reducing the risk of COVID-19 by advocating healthy lifestyle habits and preferential policies among consumers of beer and cider and spirits.
Highlights
Coronavirus disease 2019 (COVID-19) pandemic has revealed how readily viruses spread in our interconnected world
Subjects who usually consumed alcohol within guidelines were not associated with COVID-19 risk (1.04 [0.97, 1.12]) compared with nondrinkers; those consumers above guidelines had a tendency of a higher risk of COVID-19 (1.09 [1.00, 1.20]), and those consumers double above the guidelines or more had a 12% higher risk of COVID-19 (1.12 [1.00, 1.25]) compared with non-drinkers
Heavy drinking is not recommended for all alcoholic beverages
Summary
Coronavirus disease 2019 (COVID-19) pandemic has revealed how readily viruses spread in our interconnected world. Epidemiological characteristics and risk factors (e.g., age, obesity, and lifestyle factors) of COVID-19 have been rapidly reported [1,2,3,4,5], the risk or protective factors for COVID-19 infection are largely unknown. The association of alcohol consumption with the risk of COVID-19 infection or pneumonia was inconsistent [12,13,14,15], and the associations of status, amount, and frequency of different alcoholic beverages with the risk of COVID-19 and associated mortality have not been systematically investigated. In the present large longitudinal observational study, we systematically investigated the associations of alcohol consumption (status, frequency, amount, and subtype of alcoholic beverages) with COVID-19 risk and associated mortality after adjusting for several confounders. We further examined the “dose” -response association between alcohol consumption and COVID-19 risk by drawing the risk trajectory of COVID-19 with different amounts of alcohol consumption
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