Abstract

INTRODUCTION: The United States has rapidly emerged as the epicenter for the novel coronavirus (COVID-19) pandemic. Chronic alcohol use (CAU) is associated with worsening outcomes in disorders such as pneumonia, ARDS, and gastrointestinal bleeds. Studies indicate chronic alcohol use may increase the susceptibility to respiratory infections, including potentially COVID-19. However, the effect of chronic alcohol use on outcomes in patients with COVID-19 viral infection is currently unknown. This study aims to assess the effect of chronic alcohol use (CAU) on the outcomes of patients admitted with COVID-19 infection in a suburban safety-net hospital in New York. METHODS: A retrospective single-center study of 640 patients (age ≥ 18 y) admitted to our facility from March 9, 2020 to April 20, 2020 with the diagnosis of COVID-19 infection. Presence of current or past alcohol use was documented in all COVID-19 patients able to provide history. The primary outcome was all-cause in-hospital mortality; other hospitalization outcomes including cardiac arrests, ARDS, arrhythmia, shock, and intubation rate were measured. Chi-square tests and independent T-sample tests were used to analyze categorical and continuous variables, respectively. Multivariate logistic regression analyses were performed to measure the odds of in-patient mortality and other outcomes. All statistical analyses were performed using SPSS. RESULTS: Of total 640 patients, 88 (13.0%) reported a history of chronic alcohol use (CAU), 460 (67%) denied and 91 (13.4%) were unable to provide history. Patients with CAU did not have a statistically elevated risk of mortality than those without alcohol use (25.0% vs. 31.5%, P = 0.031), lower rates of acute kidney injury (14.8% vs. 26.6%, P = 0.027) and higher rates of atrial fibrillation (5.7% vs. 3.3%, P = 0.006). No statistical difference was seen between groups on other factors of morbidity including ICU admission, intubation, cardiac arrest or septic shock. Patients with alcohol use had higher rates of diabetes, and concurrent tobacco and illicit drug use. Mean age in CAU was 55.8 vs. 58.9 in no alcohol use (SD 14.9, P = 0.068). There was no statistical difference between two groups in hospital or ICU length of stay. CONCLUSION: Chronic immunosuppression from alcohol use and associated liver dysfunction may not be a significant contributing factor to worsening outcomes in patients with concomitant COVID 19 infection.Table 1.: Demographic and clinical outcomes of alcohol dependence vs. no alcohol dependence based on documented history

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