Alcohol consumption and the risk of coronavirus disease 2019: A prospective cohort study

We investigated whether higher amounts and frequencies of alcohol use were associated with increased risk of Coronavirus disease 2019 (COVID-19). A total of 15,980,069 individuals who underwent routine health examinations between 2009 and 2010 were followed from November 13, 2020 until July 6, 2021 for COVID-19 incidence through national database linkage. Alcohol use was assessed via a structured questionnaire. Cox proportional hazards model was used to estimate adjusted HRs. During follow-up, 47,308 individuals were diagnosed with COVID-19. Compared with current nondrinkers, individuals consuming <2, 2 to 3.9, 4 to 6.9, and ≥7 drinks per day had hazard ratios (HRs) of 1.04 (95% confidence interval: 1.01-1.06), 1.13 (1.09-1.18), 1.17 (1.12-1.23), and 1.22 (1.14-1.31), respectively (P for trend <.001). For alcohol use frequency, those drinking 1 to 2, 3 to 4, and 5 to 7 days per week had HRs of 1.08 (1.05-1.10), 1.19 (1.14-1.23), and 1.11 (1.05-1.17), respectively, compared with those drinking less than once per week (P for trend <.001). Associations were stronger in women; even <1 drink per day was associated with elevated risk (HR = 1.06; 95% confidence interval: 1.02-1.10). Age-specific associations differed by sex. Higher amounts and more frequent alcohol intake were associated with higher risk of COVID-19. Associations varied by sex and age. Further studies are needed to clarify whether sex- and age-specific public health guidance on alcohol consumption can reduce COVID-19 transmission.