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Influence of vaccination on adverse health outcomes after SARS-CoV-2 infection among individuals with alcohol use disorder: a population-based study.
Askgaard, Gro; Osler, Merete; Laursen, Thomas Munk; Hjorthøj, Carsten; Benros, Michael E; Ethelberg, Steen; Mølbak, Kåre; Nordentoft, Merete; Nilsson, Sandra Feodor.
  • Askgaard G; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark.
  • Osler M; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
  • Laursen TM; Section of Gastroenterology and Hepatology, Medical Department, Zealand University Hospital, Køge, Denmark.
  • Hjorthøj C; Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark.
  • Benros ME; Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Ethelberg S; The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark.
  • Mølbak K; iPSYCH-The Lundbeck Foundation Initiative for Integrated Psychiatric Research, Aarhus, Denmark.
  • Nordentoft M; Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
  • Nilsson SF; Copenhagen Research Center for Mental Health-CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark.
Addiction ; 118(8): 1482-1492, 2023 08.
Article in English | MEDLINE | ID: covidwho-2250410
ABSTRACT
BACKGROUND AND

AIMS:

Alcohol use disorders (AUD) have not been included in the priority groups for early vaccine against SARS-CoV-2. We aimed to determine adverse outcomes after SARS-CoV-2 infection among individuals with AUD and how this is modified by vaccination. DESIGN, SETTING AND

PARTICIPANTS:

This was a registry-based cohort study carried out in Denmark, 27 February 2020 to 15 October 2021, comprising 2157 individuals with AUD and 237 541 without AUD who had had a polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection during the study period. MEASUREMENTS The association of AUD with the absolute and relative risk of hospitalization, intensive care and 60-day mortality after SARS-CoV-2 infection and of all-cause mortality throughout the follow-up period were measured. Potential interactions with SARS-CoV-2 vaccination, education and sex were explored in stratified analyses and tested by including interaction terms and using likelihood ratio tests.

FINDINGS:

Individuals with AUD had an increased absolute and relative risk of adverse outcomes, including hospitalization [incidence rate ratio (IRR) = 1.72, 95% confidence interval (CI) = 1.51-1.95], intensive care (IRR = 1.47, 95% CI = 1.07-2.02) and 60-day mortality [mortality rate ratio (MRR) = 2.35, 95% CI = 1.94-2.85] compared with SARS-CoV-2-positive individuals without AUD. Irrespective of AUD, highest risks of these adverse health outcomes were observed for individuals not vaccinated against SARS-CoV-2 infection, for individuals of low educational level and in males. However, for all-cause mortality throughout the follow-up period, SARS-CoV-2 infection showed a lower relative mortality risk increase, whereas being unvaccinated showed a higher relative mortality risk increase, in individuals with AUD than in the reference population without AUD (P of interaction tests < 0.0001).

CONCLUSIONS:

Both alcohol use disorder and being unvaccinated for SARS-CoV-2 appear to be independent risk factors for adverse health outcomes following SARS-CoV-2 infection.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Alcoholism / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans / Male Language: English Journal: Addiction Journal subject: Substance-Related Disorders Year: 2023 Document Type: Article Affiliation country: Add.16196

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Alcoholism / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans / Male Language: English Journal: Addiction Journal subject: Substance-Related Disorders Year: 2023 Document Type: Article Affiliation country: Add.16196