Initial insights into the relationship between symptomatic COVID-19 disease and specific clinical and blood...

Patients with alcohol use disorder (AUD) are at higher risk for long-term Coronavirus Disease 2019 (COVID-19) related consequences, due to bidirectional relationship and shared biological pathways between chronic alcohol use and COVID-19 disease. However, they are significantly underrepresented in the literature examining adverse outcomes associated with COVID-19 disease.

Therefore, we comprehensively examined the initial group differences between AUD patients who experienced symptomatic COVID-19 disease and AUD patients without a history of COVID-19 disease. We investigated differences between COVID-19 and non-COVID-19 groups in AUD severity (alcohol use, alcohol craving), cognitive functions (assessed by the Montreal Cognitive Assessment), and basic blood parameters.

This pilot study was conducted in two study points 6 months apart. Participants were 32 COVID-19 AUD patients and 31 non-COVID-19 AUD patients, who met rigorous inclusion and exclusion criteria. Sociodemographic questionnaire, COVID-19 interview and validated measurement instruments (5.0.0. Mini International Neuropsychiatric Interview, M.I.N.I.; Penn Alcohol Craving Scale, PACS; Alcohol Use Disorders Identification Test, AUDIT; Montreal Cognitive Assessment, MoCA; Clinical Institute Withdrawal Assessment for Alcohol Scale, Revised, CIWA-Ar) were assessed. Also, blood parameters were measured: erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) as inflammatory; alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transferase (GGT) as biochemical; total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) as lipid parameters.

In the COVID-19 group, 93.7 % of participants had a mild form of the disease. There was significant difference between the two groups in cognitive functions which improved in the non-COVID-19 group, whereas they remained unchanged in the COVID-19 group [F _{(1, 56.157)} = 6.875, p = 0.011]. TC showed distinct pattern over time in the COVID-19 group [F _{(1, 49.997)} = 18.234, p = < 0.001]. CRP showed a weak negative relationship with the time since recovery from COVID-19 (b = -0.025, p = 0.009). The non-relapse group also showed an improvement in cognitive functions after six months, in contrast to the relapse group [F _{(1, 56.157)} = 6.879, p = 0.011]. In all participants, HDL levels increased after six months [F _{(1, 58.036)} = 4.604, p = 0.036].

Cognitive functions and blood parameters require long-term follow-up in COVID-19 AUD patients. Better clinical and blood outcomes in non-relapse group support the overall benefits of reduction in alcohol use.