Impact of Alcohol Misuse on Cognitive and Respiratory Outcomes in COVID-19-associated Acute Respiratory Failure

滥用酒精对 COVID-19 相关急性呼吸衰竭患者认知和呼吸结果的影响

• 批准号: 10491334
• 负责人: ELLEN L BURNHAM
• 金额: $ 27.33万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-22 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10491334
• 关键词: Accounting; Acute; Acute Respiratory Distress Syndrome; Acute respiratory failure; Address; Admission activity; Adult; Alcohol consumption; Alcohols; Automobile Driving; Brain; COVID-19; COVID-19 pandemic; COVID-19 patient; COVID-19 survivors; COVID-19/ARDS; Characteristics; Clinic; Cognition; Cognitive; Colorado; Consumption; Convalescence; Coronavirus; Critical Illness; Data; Delirium; Development; Diagnosis; Enrollment; Functional disorder; Funding; Goals; Health; Health system; High Prevalence; Hospitalization; Hospitals; Hypoxemic Respiratory Failure; Impaired cognition; Impairment; Infection; Intensive Care Units; Intervention; Investigation; Lung; Mechanical Ventilators; Mechanical ventilation; Mental Health; Monoclonal Antibody R24; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Neurocognitive; Outcome; Patients; Post-Acute Sequelae of SARS-CoV-2 Infection; Predisposition; Recording of previous events; Recovery; Reporting; Research; Residual state; Resources; Respiration Disorders; Respiratory Failure; Respiratory physiology; Retrospective cohort; Risk; Risk Factors; Role; Services; Severities; Severity of illness; Subgroup; Survivors; Universities; Waxes; Work; alcohol misuse; alcohol research; brain dysfunction; cohort; health assessment; improved; lung development; lung injury; mental state; mortality; multidisciplinary; pandemic disease; prospective; pulmonary function; respiratory; respiratory health; response

Project Summary/Abstract During the Coronavirus (COVID)-19 pandemic, the number of patients diagnosed with the acute respiratory distress syndrome (ARDS) has increased dramatically in the US. COVID-19-associated ARDS is characterized by high morbidity, including a requirement for protracted mechanical ventilator support. In a substantial percentage of patients who survive hospitalization, deficits including neurocognitive dysfunction and residual pulmonary impairment have been reported as so-called Post-Acute Sequelae of COVID-19 (PASC). Therefore, it is imperative to urgently establish addressable factors that drive poor outcomes. Prior to the COVID-19 pandemic, investigations by our research group demonstrated that alcohol misuse is associated with an increased severity of ARDS, which may contribute to residual pulmonary dysfunction in survivors. Alcohol misuse can also propagate development of delirium that may increase risk for cognitive impairment in recovery. Notably, delirium has been reported in half of all COVID-19 patients in the ICU, and alcohol misuse appears to increase odds for its development. Although reports of increasing alcohol misuse during the pandemic are widespread and might be one modifiable factor driving severity of illness and outcomes, its impact on the trajectory of illness in COVID-19 has not been fully evaluated. The goal of this proposal is to determine if alcohol misuse promotes ICU delirium that in turn increases requirements for mechanical ventilation among patients with COVID-19-associated ARDS. Also, we wish to establish if alcohol misuse contributes to persistent cognitive and respiratory PASC in COVID-19 survivors. To address these questions, two aims are proposed. Aim 1: In hospitalized patients with COVID-19-associated ARDS, determine if alcohol misuse is associated with increased mechanical ventilation requirements, and if delirium further influences this relationship. Investigations will be conducted in a prospectively enrolled cohort of patients with COVID-19- associated ARDS, who are in the ICU at the University of Colorado Hospital (Aim 1a), and in a retrospective cohort of hospitalized patients with COVID-19, previously admitted in the University of Colorado Health system (Aim 1b). Aim 2: Among patients recovering from COVID-19, determine the impact of alcohol misuse on cognition and respiratory function in recovery, accounting for characteristics of acute illness that include requirements for mechanical ventilation and ICU delirium. Investigations will be conducted in patients followed in a multidisciplinary COVID-19 Recovery Clinic, who will have cognitive, mental, and respiratory health evaluated over the year following hospital discharge. Our proposed research will help determine if patients with alcohol misuse warrant targeted strategies to identify and treat delirium in the setting of COVID-19-associated respiratory failure, and it will clarify if hospitalized patients with COVID-19 and alcohol misuse represent a unique subgroup at risk for PASC who may merit specific services or interventions.

项目总结/文摘