Understanding how alcohol use affects adolescent COVID-19 acquisition and disease course overtime

六分之一的14-17岁青少年（16.3%）的COVID-19检测呈阳性。了解赋予的因素 鉴于青少年处于脆弱的发展阶段，增加风险势在必行。一个特别突出的风险是 因素可能是酒精使用，因为强烈的酒精使用会对免疫系统功能产生负面影响 和睡眠模式，也因为与他人饮酒可能会导致抑制力降低， 减少社会距离。COVID-19也可能影响青少年的消费方式 酒精，可能导致终身后果。了解大流行经验如何影响 饮酒的频率和强度对于确保青年获得充分的治疗支助是必要的。它还 了解酒精如何影响COVID-19疾病进程至关重要，包括严重程度和长期影响。 对身心健康的影响。 这一大流行病还使长期存在的卫生不平等现象具体化。事实上，大量数据表明， 黑人/非洲裔美国人和西班牙裔人更有可能感染COVID-19， 病情恶化。对于那些认为自己是性和性别少数群体（SGM）的人来说也是如此。 在大流行之前，高中年龄的SGM青年报告的饮酒率高于非SGM青年， 而西班牙裔和白色青年的比例相似，黑人/非裔美国人的比例明显较低 青年确保我们了解大流行病经历和酒精如何共同带来风险 对这些少数群体青少年人口采取类似和不同的做法，是解决差异问题的根本。 为了响应RFA-AA-21-002，我们建议招募和调查2,500名14-18岁的青少年，其中500人将 在过去的3个月里，他们对COVID-19的检测呈阳性，其中2,000人从未对COVID-19的检测呈阳性。 新冠肺炎。使用研究小组以前成功实施的程序，青少年将被 在社交媒体上招募并在线调查。这将提供一个全国范围，同时赋予青年权力， 在安全的时间和地点参与这个敏感的调查话题。青少年在测试中呈阳性， 基线时的COVID-19将被要求回顾性报告他们的疾病严重程度、进展和结局， 以及他们目前的新冠肺炎相关症状。无论是积极的年轻人还是积极的年轻人 COVID-19阴性将提供有关他们过去和当前饮酒的信息，以及过去和 当前的COVID保护和风险行为。然后，所有青少年将前瞻性随访24个月。他们 将在6个月、12个月、18个月和24个月完成全面的在线调查， 查询中间月份的关键风险敞口和结果。我们的主要风险将是1）酒精使用， 过去30天，2）过去30天酗酒，3）酒精使用障碍。我们的主要成果 衡量标准将是：1）COVID-19感染; 2）症状的程度和3）症状的持续时间。 研究结果将对公共卫生应对这一流行病和未来流行病产生短期和长期影响。

One in six 14-17 year-olds (16.3%) have tested positive for COVID-19. Understanding the factors that confer increased risk is imperative given adolescents’ vulnerable developmental stage. One particularly salient risk factor may be alcohol use, both because intense alcohol use negatively impacts immune system functioning and sleep patterns, and also because consuming alcohol with others could lead to lowered inhibitions that result in reduced social distancing. COVID-19 also may be impacting the way in which adolescents consume alcohol, potentially with life-long consequences. Understanding how pandemic experiences have affected the frequency and intensity of alcohol use is necessary for ensuring sufficient treatment supports for youth. It also is crucial to know how alcohol may affect the COVID-19 disease course, including the severity and long-term impact on somatic and mental health. The pandemic also has reified long-standing health inequities. Indeed, data overwhelming suggest that Black/African American and Hispanic people are significantly more likely to acquire COVID-19, and to have a worse disease course. The same is true for people who identify as a sexual and gender minority (SGM). Before the pandemic, high school-aged SGM youth reported higher rates of alcohol use than non-SGM youth, whereas rates were similar for Hispanic and White youth and significantly lower for Black/African American youth. Ensuring that we understand how pandemic experiences and alcohol together may be conferring risk similarly and differently for these minority adolescent populations is fundamental to addressing disparities. In response to RFA-AA-21-002, we propose to recruit and survey 2,500 14-18 year-olds, 500 of whom will have tested positive for COVID-19 in the past 3 months and 2,000 of whom will have never tested positive for COVID-19. Using procedures successfully implemented by the research team previously, adolescents will be recruited on social media and surveyed online. This will afford a national scope while empowering youth to engage in this sensitive survey topic where and when it is safe for them. Youth who have tested positive for COVID-19 at baseline will be asked to retrospectively report their disease severity, progression, and outcomes, as well as their current COVID-19-related symptoms. Both youth who have been positive and those who are negative for COVID-19 will provide information about their past and current alcohol use, as well as past and current COVID-protective and -risk behaviors. All youth then will be prospectively followed for 24 months. They will complete comprehensive online surveys at 6-, 12-, 18- and 24-months, and brief, monthly surveys that query the key exposures and outcomes in the in-between months. Our main exposures will be 1) alcohol use in the past 30 days, 2) binge drinking in the past 30 days, and 3) alcohol use disorder. Our main outcome measures will be: 1) COVID-19 acquisition; 2) the extent of and 3) length to which symptoms are experienced. Findings will have both short- and long-term impact on the public health response to this and future pandemics.