Association of binge alcohol use with functional outcomes among individuals with COVID-19 infection

Abstract

Aims: Alcohol consumption along with negative sequelae from excess alcohol intake increased during the COVID-19 pandemic. We evaluated the association between binge alcohol use and long-term functional outcomes among COVID-19-positive individuals.

Methods: Using a prospective, longitudinal, multisite cohort study design, we evaluated the association between binge alcohol use and mental and physical functional outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores three and six months postinfection. Eligible patients were those who presented with COVID-19-like symptoms, tested positive for COVID-19, and completed a three-month survey. Binge drinking was identified at the time of infection using the Tobacco, Alcohol, Prescription medication and other Substance use screener. Generalized estimating equation models, adjusted for demographic characteristics, social determinants of health, substance use, comorbidities, and COVID-19 vaccine status, were used to assess the association between binge alcohol use and mental and physical functional outcomes.

Results: Of 3529 individuals, 23.7% screened positive for binge drinking. At three months, prior self-reported binge drinking was associated with differences in physical function [estimate: 1.08; 95% confidence interval (CI) 0.44, 1.71], pain interference (estimate: -0.86; 95% CI -1.57, -0.15), and physical health (estimate: 1.09; 95% CI 0.43, 1.75). At six months, no associations were found between binge drinking and outcomes.

Conclusions: Binge alcohol use before COVID-19 infection was associated with statistically significant but clinically irrelevant improvements in function at three months, which were not sustained at six months. Postinfectious and postpandemic stressors may have played a larger impact on functional outcomes than binge alcohol use. A higher frequency of binge drinking and its association with functional outcomes, particularly among individuals with COVID-19 warrants further study.

Keywords: COVID-19 infection; alcohol use; binge alcohol.

Figure 1

Marginal estimates from GEE analysis for functional outcomes for binge alcohol drinkers in reference to nonbinge drinkers at 3 and 6 months for the cohort who tested positive at the index COVID-19 test. Note: Marginal estimates from GEE analysis for functional outcomes for binge alcohol drinkers in reference to nonbinge drinkers are calculated. Three-month estimates include participants with baseline and 3-month surveys. Six-month estimates include a subset of these participants, for which 6-month surveys were available. PROMIS outcome measures include T-scores from PROMIS-29 domains: anxiety, depression, fatigue, pain interference, sleep disturbance, physical function, and social function. An additional measure for pain intensity (scaled 0–10) is included. Cognitive function is measured using PROMIS SF-CF 8a. Physical and mental health summary scores are also analyzed as outcome measures.