Factors influencing COVID-19 Infection in older individuals: History of Alcohol Use Disorder, Major Depressive illness, genetic variation and current use of alcohol.
Factors influencing COVID-19 Infection in older individuals: History of Alcohol Use Disorder, Major Depressive illness, genetic variation and current use of alcohol.
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影响老年人感染 COVID-19 的因素：酒精使用障碍史、重度抑郁症、遗传变异和当前饮酒情况。
DOI：
10.1101/2021.12.06.21267386
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Locke-Wellman,Jeannette
中科院分区：
文献类型：
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作者：
Hill,ShirleyY;Holmes,BrianJ;Locke-Wellman,Jeannette
2019冠状病毒病（COVID-19）大流行仍然是一个主要的公共卫生问题。易受感染人群包括老年人，据推测免疫反应减弱。确定影响COVID-19感染的因素可以为保护这些人提供额外的手段。MethodsMembers of a family study previously interviewed as middle aged individuals are received and asked to participate in extended phone interview（2-3 hours）涵盖过去和现在的心理健康问题，身体健康诊断，酒精和药物的使用，以及接触任何人与COVID-19。平均随访时间为32年。收集详细的药物使用情况，以确认医学诊断，并揭示医生目前为参与者开具的特定药物类别可能的保护作用。可获得红细胞抗原（ABO、Kell、Duffy、Kidd、Rhesus）和HLA亚型的血清学结果。进行了分析，以对比COVID-19 +和COVID-19 −个体的身心健康诊断，酒精和药物的使用以及红细胞和HLA血清学。此外，还进行了分析，以将这些群体与报告已知暴露但没有COVID-19症状或卫生专业人员诊断的群体进行对比。结果访谈于2020年9月至2021年11月期间完成。在接受采访的90人中，共有42人在采访时接种了疫苗。在接受采访时，11.1%的人报告已患上COVID-19。在过去的一个月里，根据饮酒的类型，使用每次数量（QPO）和频率数量（QXF）总数，我们发现QPO对白酒的影响（p=0.017）和QXF对白酒消费的边际效应（p=0.06）之间存在显着关联。暴露于COVID-19阴性的人往往比阳性的人喝更多的酒，平均每天喝一杯。啤酒和葡萄酒的消费量没有统计学意义。在基线评估时诊断为酒精使用障碍并不是COVID阳性或阴性的重要预测因素。自我报告的当前抑郁症或过去的抑郁症并不能预测COVID-19状态，这是基于一个简单的问题“你目前抑郁还是过去抑郁？”。与此相反，完成临床访谈，旨在引起抑郁情绪和并发症状，以确定一生中是否存在抑郁发作没有显示出显着的效果。基线与随访时的反应比较显示，对COVID-19发展最有弹性的是那些在两个时间点都没有终身病史的抑郁发作证据的人。分析了在我们的样本中经常发生的身体健康问题，如高血压，但没有发现显着。对BMI进行了分析，发现无统计学显著性。对整个样本的HLA变异分析没有显示出显著的相关性，但在男性中，两种变异A1和B8确实显示出与COVID-19+和COVID-19−状态相关的显著变异。对红细胞抗原的分析揭示了一个显著的红细胞效应;基德基因型变异与COVID-19状态相关。解释我们初步得出结论，使用特定类型的酒精，即白酒，与COVID-19的频率降低有关。但是，量很低，平均每天约1杯。需要放大的样品来确认这些结果。酒精使用障碍的既往史不会增加发展COVID-19的可能性，这一发现...
IntroductionThe Coronavirus Disease 2019 (COVID-19) pandemic continues to be a major public health problem. Vulnerable populations include older individuals with presumed weakening of the immune response. Identification of factors influencing COVID-19 infection could provide an additional means for protecting such individuals.MethodsMembers of a family study previously interviewed as middle aged individuals were re-contacted and asked to participate in extended phone interview (2–3 hours) covering past and current mental health issues, physical health diagnoses, use of alcohol and drugs, and exposure to anyone with COVID-19. The average follow-up period was 32 years. Detailed medication use was collected to confirm medical diagnoses and to reveal possible protective effects of particular drug classes currently prescribed for the participant by their physician. Serology was available for red cell antigens (ABO, Kell, Duffy, Kidd, Rhesus) and HLA subtypes. Analyses were conducted to contrast COVID-19 + and COVID-19 − individuals for physical and mental health diagnoses, use of alcohol and drugs, and red cell and HLA serology. Additionally, analyses were conducted to contrast these groups with a group reporting known exposure but absence of COVID-19 symptoms or diagnosis by a health professional.ResultsInterviews were completed between September 2020 and November 2021. A total of 42 of the 90 individuals interviewed had been vaccinated at the time of interview. At the time of interview, 11.1% reported having developed COVID-19. Using quantity per occasion (QPO) and quantity by frequency (QXF) totals in the past month by type of alcohol consumed, we found a significant association between QPO for liquor (p=0.017) and marginal effects for QXF for liquor consumption (p=0.06). Exposed individuals who were COVID-19 negative tended to drink more liquor than those who were positive, an average of about one drink per day. Beer and wine consumption were not statistically significant. A diagnosis of alcohol use disorder at baseline evaluation was not a significant predictor of being COVID positive or negative. Self-reported current depression or depression in the past only was not a predictor of COVID-19 status based on a single question “Are you depressed currently or only in the past?”. In contrast, completion of a clinical interview designed to elicit depressed mood and concurrent symptoms for determination of the lifetime presence or absence of a depressive episode did reveal a significant effect. Comparison of responses at baseline to follow-up showed those most resilient to developing COVID-19 were those without evidence of a depressive episode by lifetime history at both points in time. Physical health issues were analyzed for those that were frequently occurring in our sample such as hypertension but not found to be significant. BMI was analyzed and found to be statistically non-significant. Analysis of HLA variation across the whole sample did not reveal a significant association but among males two variants, A1 and B8, did show significant variation associated with COVID-19+ and COVID-19− status. Analyses of the red cell antigens revealed one significant red cell effect; Kidd genotypic variation was associated with COVID-19 status.InterpretationWe tentatively conclude that use of specific types of alcohol, namely liquor, is associated with reduced frequency of COVID-19. However, the amount is low, averaging about 1 drink per day. Enlarged samples are needed to confirm these results. The finding that past history of alcohol use disorder does not increase likelihood of developing COVID-19 is …