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

每六名14-17岁的青少年中就有一人(16.3%)新冠肺炎检测呈阳性。了解授权的因素 鉴于青少年处于脆弱的发育阶段，增加风险势在必行。一个特别突出的风险 因素可能是酗酒，两者都是因为酗酒对免疫系统功能有负面影响 以及睡眠模式，还因为与他人一起饮酒可能会导致抑制作用降低，从而 从而减少了社交距离。新冠肺炎也可能正在影响青少年的消费方式 酒精，可能会产生终生后果。了解大流行经历如何影响 酒精使用的频率和强度对于确保为青少年提供足够的治疗支持是必要的。它还 了解酒精可能如何影响新冠肺炎的病程至关重要，包括严重程度和长期 对身体和精神健康的影响。 这场大流行还使长期存在的健康不平等现象具体化。事实上，压倒性的数据表明 黑人/非裔美国人和西班牙裔人更有可能获得新冠肺炎，并拥有 更糟糕的病程。同样的道理也适用于那些认为自己是性少数和性别少数(SGM)的人。 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， 而西班牙裔和白人青年的比率相似，黑人/非裔美国人的比率则低得多 青春年华。确保我们了解大流行经历和饮酒一起可能会增加风险 同样和不同的是，对这些少数群体的青少年人口来说，这是解决差距的根本。 针对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名将 在过去的3个月里，我的新冠肺炎检测呈阳性，其中2,000人永远不会检测出阳性 新冠肺炎。使用研究小组之前成功实施的程序，青少年将被 在社交媒体上招募并在网上进行调查。这将提供一个全国性的范围，同时赋予年轻人 在对他们安全的时间和地点参与这一敏感的调查主题。检测结果呈阳性的年轻人 基线的新冠肺炎将被要求回顾报告他们的疾病严重性、进展和结果， 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 新冠肺炎将提供他们过去和现在饮酒的信息，以及过去和现在的饮酒情况 当前的COVID防护和危险行为。然后，所有的年轻人都将被前瞻性地跟踪24个月。他们 将在6个月、12个月、18个月和24个月内完成全面的在线调查，并按月完成简短的调查 查询中间月份的关键风险敞口和结果。我们的主要接触将是1)饮酒 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 衡量标准是：1)收购新冠肺炎；2)出现症状的程度和持续时间。 这些发现将对应对此次和未来大流行的公共卫生对策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.