Influence of vaccination on adverse health outcomes after SARS-CoV-2 infection among individuals with alcohol use disorder: a population-based study

Gro Askgaard; Merete Osler; Thomas Munk Laursen; Carsten Hjorthøj; Michael E Benros; Steen Ethelberg; Kåre Mølbak; Merete Nordentoft; Sandra Feodor Nilsson

doi:10.1111/add.16196

Influence of vaccination on adverse health outcomes after SARS-CoV-2 infection among individuals with alcohol use disorder: a population-based study

Gro Askgaard, Merete Osler, Thomas Munk Laursen, Carsten Hjorthøj, Michael E Benros, Steen Ethelberg, Kåre Mølbak, Merete Nordentoft, Sandra Feodor Nilsson

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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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: Registry-based cohort study.

SETTING: Denmark, 27 February 2020 until 15 October 2021.

PARTICIPANTS: 2157 individuals with AUD and 237,541 without AUD who 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 hospitalisation, intensive care and 60-day mortality after SARS-CoV-2 infection and of all-cause mortality throughout the follow-up period. Potential interactions with SARS-CoV-2 vaccination, education and sex were explored in stratified analysis 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 hospitalisation [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 gave a lower relative mortality risk increase, whereas being unvaccinated gave 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.

Originalsprog	Engelsk
Tidsskrift	Addiction
Vol/bind	118
Udgave nummer	8
Antal sider	11
ISSN	0965-2140
DOI	https://doi.org/10.1111/add.16196
Status	Udgivet - 2023

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10.1111/add.16196Licens: CC BY-NC

FulltextForlagets udgivne version, 604 KBLicens: CC BY-NC

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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.

I: Addiction, Bind 118, Nr. 8, 2023.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Askgaard, Gro ; Osler, Merete ; Laursen, Thomas Munk ; Hjorthøj, Carsten ; Benros, Michael E ; Ethelberg, Steen ; Mølbak, Kåre ; Nordentoft, Merete ; Nilsson, Sandra Feodor. / Influence of vaccination on adverse health outcomes after SARS-CoV-2 infection among individuals with alcohol use disorder : a population-based study. I: Addiction. 2023 ; Bind 118, Nr. 8.

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title = "Influence of vaccination on adverse health outcomes after SARS-CoV-2 infection among individuals with alcohol use disorder: a population-based study",

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: Registry-based cohort study.SETTING: Denmark, 27 February 2020 until 15 October 2021.PARTICIPANTS: 2157 individuals with AUD and 237,541 without AUD who 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 hospitalisation, intensive care and 60-day mortality after SARS-CoV-2 infection and of all-cause mortality throughout the follow-up period. Potential interactions with SARS-CoV-2 vaccination, education and sex were explored in stratified analysis 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 hospitalisation [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 gave a lower relative mortality risk increase, whereas being unvaccinated gave 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.",

author = "Gro Askgaard and Merete Osler and Laursen, {Thomas Munk} and Carsten Hjorth{\o}j and Benros, {Michael E} and Steen Ethelberg and K{\aa}re M{\o}lbak and Merete Nordentoft and Nilsson, {Sandra Feodor}",

year = "2023",

doi = "10.1111/add.16196",

language = "English",

volume = "118",

journal = "Addiction",

issn = "0965-2140",

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TY - JOUR

T1 - Influence of vaccination on adverse health outcomes after SARS-CoV-2 infection among individuals with alcohol use disorder

T2 - a population-based study

AU - Askgaard, Gro

AU - Osler, Merete

AU - Laursen, Thomas Munk

AU - Hjorthøj, Carsten

AU - Benros, Michael E

AU - Ethelberg, Steen

AU - Mølbak, Kåre

AU - Nordentoft, Merete

AU - Nilsson, Sandra Feodor

PY - 2023

Y1 - 2023

N2 - 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: Registry-based cohort study.SETTING: Denmark, 27 February 2020 until 15 October 2021.PARTICIPANTS: 2157 individuals with AUD and 237,541 without AUD who 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 hospitalisation, intensive care and 60-day mortality after SARS-CoV-2 infection and of all-cause mortality throughout the follow-up period. Potential interactions with SARS-CoV-2 vaccination, education and sex were explored in stratified analysis 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 hospitalisation [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 gave a lower relative mortality risk increase, whereas being unvaccinated gave 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.

AB - 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: Registry-based cohort study.SETTING: Denmark, 27 February 2020 until 15 October 2021.PARTICIPANTS: 2157 individuals with AUD and 237,541 without AUD who 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 hospitalisation, intensive care and 60-day mortality after SARS-CoV-2 infection and of all-cause mortality throughout the follow-up period. Potential interactions with SARS-CoV-2 vaccination, education and sex were explored in stratified analysis 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 hospitalisation [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 gave a lower relative mortality risk increase, whereas being unvaccinated gave 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.

U2 - 10.1111/add.16196

DO - 10.1111/add.16196

M3 - Journal article

C2 - 37005828

VL - 118

JO - Addiction

JF - Addiction

SN - 0965-2140

IS - 8

ER -