Abstract：
BACKGROUND: Nurses and other first responders are at high risk of exposure to the SARS-CoV2 virus, and many have developed severe COVID-19 infection. A better understanding of the factors that increase the risk of infection after exposure to the virus could help to address this. Although several risk factors such as obesity, diabetes, and hypertension have been associated with an increased risk of infection, many first responders develop severe COVID-19 without established risk factors. As inflammation and cytokine storm are the primary mechanisms in severe COVID-19, other factors that promote an inflammatory state could increase the risk of COVID-19 in exposed individuals. Alcohol misuse and shift work with subsequent misaligned circadian rhythms are known to promote a pro-inflammatory state and thus could increase susceptibility to COVID-19. To test this hypothesis, we conducted a prospective, cross-sectional observational survey-based study in nurses using the American Nursing Association network.
METHODS: We used validated structured questionnaires to assess alcohol consumption (the Alcohol Use Disorders Identification Test) and circadian typology or chronotype (the Munich Chronotype Questionnaire Shift -MCTQ-Shift).
RESULTS: By latent class analysis (LCA), high-risk features of alcohol misuse were associated with a later chronotype, and binge drinking was greater in night shift workers. The night shift was associated with more than double the odds of COVID-19 infection of the standard shift (OR 2.67, 95% CI: 1.18 to 6.07). Binge drinkers had twice the odds of COVID-19 infection of those with low-risk features by LCA (OR: 2.08, 95% CI: 0.75 to 5.79).
CONCLUSIONS: Working night shifts or binge drinking may be risk factors for COVID-19 infection among nurses. Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce.
METHODS: We used validated structured questionnaires to assess alcohol consumption (the Alcohol Use Disorders Identification Test) and circadian typology or chronotype (the Munich Chronotype Questionnaire Shift -MCTQ-Shift).
RESULTS: By latent class analysis (LCA), high-risk features of alcohol misuse were associated with a later chronotype, and binge drinking was greater in night shift workers. The night shift was associated with more than double the odds of COVID-19 infection of the standard shift (OR 2.67, 95% CI: 1.18 to 6.07). Binge drinkers had twice the odds of COVID-19 infection of those with low-risk features by LCA (OR: 2.08, 95% CI: 0.75 to 5.79).
CONCLUSIONS: Working night shifts or binge drinking may be risk factors for COVID-19 infection among nurses. Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce.
摘要：
背景：护士和其他第一反应者处于暴露于SARS-CoV2病毒的高风险中，许多人出现了严重的COVID-19感染。更好地了解暴露于病毒后增加感染风险的因素可能有助于解决这一问题。尽管肥胖等几个危险因素，糖尿病,高血压与感染风险增加有关，许多急救者发展为严重的COVID-19，没有确定的危险因素。由于炎症和细胞因子风暴是严重COVID-19的主要机制，其他促进炎症状态的因素可能会增加暴露个体患COVID-19的风险。众所周知，酒精滥用和轮班工作以及随后的昼夜节律失调会促进促炎状态，因此可能会增加对COVID-19的易感性。为了检验这个假设，我们进行了一个前瞻性的，使用美国护理协会网络对护士进行横断面观察性调查研究。
方法：我们使用经过验证的结构化问卷来评估饮酒（酒精使用障碍鉴定测试）和昼夜节律类型或时间型（慕尼黑时间型问卷移位-MCTQ-移位）。
结果：通过潜在类别分析（LCA），酒精滥用的高风险特征与较晚的时间类型有关，夜班工人的暴饮暴食更多。夜班与标准班COVID-19感染几率的两倍以上相关(OR2.67，95%CI：1.18至6.07)。通过LCA分析，暴饮暴食者感染COVID-19的几率是具有低风险特征者的两倍(OR：2.08，95%CI：0.75至5.79)。
结论：上夜班或酗酒可能是护士感染COVID-19的危险因素。了解这些风险因素的潜在机制可能有助于减轻COVID-19对我们面临风险的医疗保健队伍的影响。
方法：我们使用经过验证的结构化问卷来评估饮酒（酒精使用障碍鉴定测试）和昼夜节律类型或时间型（慕尼黑时间型问卷移位-MCTQ-移位）。
结果：通过潜在类别分析（LCA），酒精滥用的高风险特征与较晚的时间类型有关，夜班工人的暴饮暴食更多。夜班与标准班COVID-19感染几率的两倍以上相关(OR2.67，95%CI：1.18至6.07)。通过LCA分析，暴饮暴食者感染COVID-19的几率是具有低风险特征者的两倍(OR：2.08，95%CI：0.75至5.79)。
结论：上夜班或酗酒可能是护士感染COVID-19的危险因素。了解这些风险因素的潜在机制可能有助于减轻COVID-19对我们面临风险的医疗保健队伍的影响。
