{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T13:46:40Z","timestamp":1776433600892,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Alcohol use disorder (AUD) may induce angiotensin\u2010converting enzyme 2 (ACE2) overexpression, potentially increasing vulnerability to severe acute respiratory syndrome coronavirus\u20102 infection. However, the relationship between AUD and the risk of coronavirus disease 2019 (COVID\u201019) infection remains unclear. This study aimed to measure the association between AUD and the incidence of COVID\u201019 infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We identified 247\u2009000 individuals with AUD between 2001 and 2019 from the Taiwan National Health Insurance Research Database. Another 2\u2009470\u2009000 age\u2010 and sex\u2010matched controls without AUD were randomly selected for comparison. All study participants were followed up until the occurrence of new\u2010onset COVID\u201019 infection, death, or December 31, 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Taiwan National Health Insurance Research Database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 247\u2009000 individuals with AUD and 2\u2009470\u2009000 controls without AUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>A new diagnosis of COVID\u201019 was determined by a positive real\u2010time reverse transcriptase\u2010polymerase chain reaction test. We employed a Cox regression model, considering death as a competing risk, to assess the impact of AUD on the risk of COVID\u201019 infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Among 2\u2009717\u2009000 participants, 2374 developed incident COVID\u201019 during an average follow\u2010up of 1.98\u2009years, including 415 (0.17%) individuals with AUD and 1959 (0.08%) controls. After adjusting for age, sex, urbanization, COVID\u201019 vaccination status, anxiety disorder, and the Charlson Comorbidity Index, AUD was statistically significantly associated with a higher risk of incident COVID\u201019 infection (adjusted hazard ratio [AHR]:1.19; 95% confidence interval [CI]:1.06\u20131.34). Subgroup analyses, stratified by age, sex, and COVID\u201019 vaccination status, revealed that AUD was linked to the risk of incident COVID\u201019 infection across all subgroups, except for individuals aged 18\u201349\u2009years, men, and those who were unvaccinated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Alcohol use disorder appears to be an independent risk factor for incident COVID\u201019 infection. These findings highlight the importance of prioritizing individuals with AUD as a key target population for COVID\u201019 prevention efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70309","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T08:21:21Z","timestamp":1766564481000},"page":"1190-1198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Alcohol use disorder and risk of incident COVID\u201019 infection: A nested case\u2013control study in Taiwan"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4469-4732","authenticated-orcid":false,"given":"Yung\u2010Feng","family":"Yen","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases Taipei City Hospital, Heping Fuyou Branch  Taipei Taiwan"},{"name":"Institute of Public Health National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Department of Health Care Management National Taipei University of Nursing and Health Sciences  Taipei Taiwan"},{"name":"University of Taipei  Taipei Taiwan"},{"name":"Department of Education and Research, Taipei City Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun\u2010Ju","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Health Care Management National Taipei University of Nursing and Health Sciences  Taipei Taiwan"},{"name":"School of Medicine, National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Puli Branch of Taichung Veterans General Hospital  Nantou Taiwan"},{"name":"Department of Exercise Health Science National Taiwan University of Sport  Taichung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheng\u2010Siang","family":"Su","sequence":"additional","affiliation":[{"name":"Taipei City Psychiatric Centre Taipei City Hospital  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2773-1335","authenticated-orcid":false,"given":"Chian\u2010Jue","family":"Kuo","sequence":"additional","affiliation":[{"name":"Taipei City Psychiatric Centre Taipei City Hospital  Taipei Taiwan"},{"name":"Department of Psychiatry, School of Medicine College of Medicine, Taipei Medical University  Taipei Taiwan"},{"name":"Psychiatric Research Center Taipei Medical University Hospital  Taipei Taiwan"},{"name":"Department and Graduate Institute of Forensic Medicine, College of Medicine National Taiwan University  Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization: Coronavirus disease (COVID\u201019) Pandemic January 5 2025 https:\/\/data.who.int\/dashboards\/covid19\/deaths"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/v13020202"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2021.2004315"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.5662\/wjm.v14.i3.89761"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03120-0"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2020.110678"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202003-0541OC"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.18632\/aging.203181"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32744-2"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.2161"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2008.00842.x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14838"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114521"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v37.2.04"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-020-00880-7"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.11975"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116396"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115111"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/29.2.336"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2024.85"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.03.012"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.02.052"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.14981"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.15000"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2022.03.012"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/371593"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.2001.281.3.L575"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-0227"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp451"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2003.11.027"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph13070155"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70309","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.70309","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70309","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:49:45Z","timestamp":1776430185000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.70309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/add.70309"],"URL":"https:\/\/doi.org\/10.1111\/add.70309","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,24]]},"assertion":[{"value":"2025-02-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}