COVID-19, heavy drinking and alcohol use disorders: a national study of Veterans Administration patients

COVID-19、酗酒和酒精使用障碍：一项针对退伍军人管理局患者的全国研究

• 批准号: 10596115
• 负责人: DEBORAH S HASIN
• 金额: $ 18.72万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10596115
• 关键词: 2019-nCoV; Acute Respiratory Distress Syndrome; Address; Affect; Age; Alcohol consumption; Alcohols; Back; Behavioral; Big Data; Biological; Black Populations; Black race; COVID-19; COVID-19 prognosis; COVID-19 risk; COVID-19 severity; COVID-19 susceptibility; COVID-19 vaccination; Caring; Cause of Death; Cessation of life; Characteristics; Chronic; Computerized Medical Record; County; Data; Databases; Diabetes Mellitus; Diagnosis; Diagnostic; Disasters; Disease; Ethnic Origin; Event; Exploratory/Developmental Grant; Funding; Future; General Population; Health; Health behavior; Heavy Drinking; Hispanic; Hispanic Populations; Hospitalization; Hypertension; ICD-10-CM; Immune response; Immune system; Impairment; Individual; Infection; Intensive Care; Knowledge; Link; Logistic Regressions; Medical; Medicare; Minority; Misinformation; Modeling; National Institute on Alcohol Abuse and Alcoholism; Obesity; Outcome; Patients; Persons; Pneumonia; Policies; Poverty; Prevalence; Preventive; Process; Prognosis; Provider; Race; Research Infrastructure; Retrospective cohort; Risk; SARS-CoV-2 exposure; SARS-CoV-2 infection; SARS-CoV-2 negative; Scientist; Services; Social Environment; Statistical Data Interpretation; Stress; Testing; Time; United States Department of Veterans Affairs; Vaccinated; Vaccination; Vaccines; Veterans; Virus Diseases; Vital Status; alcohol effect; alcohol screening; alcohol use disorder; coping; cost; data repository; data resource; data sharing; data sharing networks; demographics; design; drinking; electronic medical record system; housing instability; human old age (65+); indexing; infection risk; interest; male; men; mortality; novel coronavirus; pandemic disease; residence; service providers; sex; sociodemographics; vaccine distribution; vaccine hesitancy

Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 is a global pandemic. While most COVID-19 cases are mild or moderate, severe cases (~15%) require hospitalization, critical cases (~5%) require intensive care, and many deaths occur. Males, Blacks and Hispanics are at greater risk for COVID-19 infection, and poor prognosis is predicted by older age, race/ethnicity, and prior underlying medical conditions. A potentially critical factor not yet studied is heavy alcohol use or alcohol use disorder (AU/AUD). AU/AUD could increase the risk for COVID-19 infection and poor prognosis through poor health behaviors, by direct effects of alcohol on the immune system, or by indirect effects due to the greater prevalence of underlying medical conditions that predict poor COVID-19 prognosis. Little is known about the relationship of AU/AUD to the likelihood of COVID-19 vaccination, infection, or poor prognosis, and if these relationships are modified by medical conditions (e.g., hypertension, obesity, diabetes), spatially-defined socioenvironmental or exposure variables (e.g., county poverty or COVID-19 rates) or demographic characteristics (sex, age, race/ethnicity, poverty). To study this, large databases are needed that include AU/AUD, demographic characteristics, spatial identifiers, diagnostic, treatment and mortality information. Responding to PA-20-195 (and addressing issues in NOT-AA-20-011), we will utilize the Veterans Administration (VA) Electronic Medical Record (EMR) system for this purpose. The VA treats 6.3 million veterans a year. VA patients have high rates of COVID-19 vulnerability factors, e.g., male, older age, chronic medical conditions. A VA Shared Data Resource identifies COVID-19 cases (now N=186,174, with 9,299 deaths). The many VA patients with ICD-10-CM AUD or positive alcohol (AUDIT-C) screens provide extensive data on whether the likelihood of COVID-19 outcomes differ by AU/AUD status. Leveraging a research infrastructure established in an existing project, we propose a 2-year study to comprehensively address the relationship of AU/AUD to COVID-19 vaccination, infection and prognosis, and how these relationships are affected by demographic, medical, spatial exposure characteristics. Aim1: Determine the relationship of AU/AUD to COVID-19 vaccination, infection, and in those infected, poor prognosis (e.g., hospitalization, ICU treatment, death). Aim 2: Determine if associations of AU/AUD with COVID-19 outcomes vary over time, medical conditions (e.g., hypertension, obesity, diabetes), spatial exposures or demographic characteristics. In Year 01, we will analyze EMR diagnostic, treatment, and vital status death data, using a 12-month lookback period to determine AU/AUD and medical conditions that preceded COVID-19 outcome variables. In Year 02, we will incorporate National Death Index data to examine causes of death, and expand information on veterans ≥age 65 with Medicare data. Logistic regression will evaluate differences in COVID-19 outcomes by AU/AUD status. Among those with COVID-19, survival models will determine if time to poor prognosis events differs by AU/AUD. Results will fill major gaps in knowledge about the risks for and prognosis of COVID-19 among those with AU/AUD.

由SARS-CoV-2引起的2019冠状病毒病（COVID-19）是一种全球性大流行疾病。而大多数COVID-19