Covid-19 Immunization and Disease Burden for Patients with Alcohol Use Disorder Evaluation Through the Use of an Electronic Database

Background: Alcohol consumption has increased in adults during the COVID 19 pandemic. Patients with Alcohol Use Disorder (AUD) are at a greater risk of negative outcomes from COVID 191. These include, contracting COVID-19, having a severe COVID-19 illness course, and experiencing an exacerbation of their Alcohol Use Disorder with an associated increase in morbidity and mortality. During the course of the pandemic a vaccine for COVID 19 was developed that has been demonstrated to be effective against COVID-19. Methods: We accessed the nationwide EPIC EMR (electronic medical record) database through the Cosmos application to analyze the COVID-19 infection rates, hospitalizations and deaths in the 1/20/2020-9/15/2021 timeframe. We assessed vaccination rates of patients with an encounter between 4/15/21-9/15/21 in an effort to capture patients who would have an updated medical record that had their vaccination status documented in the EMR. Results: COVID-19 infection rates were higher among patients with AUD at 7.8% compared to those without AUD at 6.9% (p<.0001). The incidence of hospitalization was higher among patients with AUD (1.5%) compared to patients without AUD (0.8%), p<.0001. The risk of death was also higher among patients with AUD (0.3%) compared to those without AUD (0.2%), p<.0001. The vaccination rate for patients with AUD was lower among patients with AUD (50.5%) compared to those without AUD (52.4%, p<.0001). Conclusions: This study demonstrates that there is a disproportionate burden of COVID-19 infections, hospitalizations, and mortality among patients with AUD. The impact of COVID-19 on the alcohol use patterns is more pronounced among patients 65 and older, males, African Americans and patients of Hispanic ethnicity.