# Alcohol and Circadian Disruption in Shift Workers Decreases their Resiliency to COVID-19

> **NIH NIH R24** · RUSH UNIVERSITY MEDICAL CENTER · 2020 · $157,000

## Abstract

ABSTRACT
Coronavirus disease 2019 (COVID-19) pandemic has upended our health care system resulting in
unprecedented morbidity, mortality. It is now clear that several host risk factors like age, obesity and
comorbidity impact rate of infection and severity of disease leading to hospital ICU admission and death. Risk
factors that promote exaggerated immune/inflammatory response to the virus that is the cause of the severe
and fatal disease outcome must be identified. One such factor could be alcohol use disorder (AUD) because:
(1) Alcohol is by far the frequently used drug in the United States, especially in those with increased
socioeconomic (SES) adversity (another risk factor for COVID-19 death); (2) AUD is already an established
risk factor for poor outcomes in hospitalized adults with influenza, a similar respiratory virus to COVID-19, and
Acute Respiratory Distress Syndrome (ARDS) – the primary cause of death in COVID-19 and (3) Both alcohol
and shift work negatively impacts immunity and inflammatory response to pathogens. Shift work has been
associated with worse alcohol effects and increased cardiovascular disease, diabetes, and obesity – all risk
factors for severe COVID19. Accordingly, we will study that increased alcohol consumption is an independent
risk factor to increase the incidence and severity of COVID-19 and that circadian misalignment is a key co-
factor decreasing resiliency of the host immune system to infection. Establishing this association is an urgent
unmet need because one key group of vulnerable populations during this pandemic is healthcare workers, who
are on the front lines for exposure and the ability of the US to protect healthcare workers is critical to
successful mitigation and suppression efforts to control the pandemic. We have formed a collaboration with the
American Nursing Association (ANA) and propose to conduct an electronic questionnaire survey of its 200,000
members to determine the impact of alcohol consumption and circadian misalignment on COVID19 disease
course. Our survey includes a demographic form (age, BMI, race, gender, Zip code to assess SES), alcohol
use disorders identification test (AUDIT), health-related quality of life (SF-8), Munich Chronotype questionnaire
(MCTQ) or MCTQ (shift), PROMIS 8 sleep and structured COVID-19 questionnaires. Aim 1: Determine if
alcohol consumption increases incidence or severity of COVID-19 in nurses and elucidate interaction
with other risk factors. We will determine if increased alcohol use and misuse are associated with poorer
health outcomes related to COVID-19 and if socioeconomic status, age, BMI, race, or pattern of alcohol use
modify the risk and/or are an independent predictor for poor health related outcomes. In addition, we will use
latent class analysis (LCA) to examine different alcohol groups related to poor outcomes. Aim 2. Determine if
circadian misalignment increases incidence or severity of COVID-19 and whether it modify alcohol
effects on COVID...

## Key facts

- **NIH application ID:** 10156681
- **Project number:** 3R24AA026801-02S2
- **Recipient organization:** RUSH UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** ALI KESHAVARZIAN
- **Activity code:** R24 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $157,000
- **Award type:** 3
- **Project period:** 2019-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10156681

## Citation

> US National Institutes of Health, RePORTER application 10156681, Alcohol and Circadian Disruption in Shift Workers Decreases their Resiliency to COVID-19 (3R24AA026801-02S2). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10156681. Licensed CC0.

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