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The aim of this study was to measure an objective biomarker of recent alcohol use in patients hospitalized with severe COVID\u201019\u2010associated respiratory failure who were enrolled in an investigational clinical trial to determine the prevalence of alcohol misuse, and to explore the relationship of alcohol use with outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a substudy of patients enrolled in the multicenter, phase 2, adaptive platform design, <jats:italic>Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging And molecular Analysis in COVID\u201019<\/jats:italic> trial (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>: NCT04488081), conducted at 20 hospital systems across the United States. Three hundred and fifty\u2010five patients with available red blood cell (RBC) samples and 60\u2010day follow\u2010up assessments were included. RBCs were utilized to measure phosphatidylethanol (PEth). Prespecified thresholds of PEth were utilized to stratify patients into groups: low\/no alcohol use (PEth\u2009&lt;\u200920\u2009ng\/mL), significant alcohol use (PEth 20\u2013200\u2009ng\/mL), and heavy alcohol use (PEth\u2009\u2265\u2009200\u2009ng\/mL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this cohort, 17% of patients met criteria for significant alcohol use, while 4% met criteria for heavy alcohol use. Alcohol misuse was associated with diminished odds for home discharge, though this finding did not achieve statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a cohort of patients with severe COVID\u201019 enrolled in a clinical trial, alcohol consumption of two or more standard drinks per day was present among 21%, approximating the proportion of patients with diabetes, and raising the possibility that alcohol consumption alters risk for severe viral pneumonia. Undetected alcohol misuse among clinical trial participants has the potential to influence study outcomes or contribute to adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15495","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T01:54:31Z","timestamp":1732672471000},"page":"165-174","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Phosphatidylethanol measures in patients with severe <scp>COVID<\/scp>\u201019\u2010associated respiratory failure identify a subset with alcohol misuse"],"prefix":"10.1111","volume":"49","author":[{"given":"Raymond","family":"Pomponio","sequence":"first","affiliation":[{"name":"Department of Biostatistics and Informatics Colorado School of Public Health  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan A.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics Colorado School of Public Health  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moses","family":"Owusu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics Colorado School of Public Health  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Slaughter","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Melgar","sequence":"additional","affiliation":[{"name":"University of Denver  Denver Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E.","family":"Jolley","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9945-0284","authenticated-orcid":false,"given":"Ellen L.","family":"Burnham","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,26]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"141","article-title":"An empirical transition matrix for nonhomogeneous Markov chains based on censored observations","volume":"5","author":"Aalen O.O.","year":"1978","journal-title":"Scandinavian Journal of Statistics"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004770"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13471"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002795"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176345976"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14838"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000767"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2007764"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2021.113915"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.2196\/33022"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109297"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chstcc.2023.100045"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13534"},{"key":"e_1_2_9_15_1","unstructured":"Centers for Disease Control and Prevention. 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