COVID-19 Roundup: Alcohol Use Disorder and Hormone Replacement Therapy Mortality

Alcohol Use Disorder Mortality1

Mortality related to alcohol use disorder (AUD) increased among all ages during the COVID-19 pandemic, with the largest increase among individuals aged 25 to 44 years, according to the results of a cross-sectional, projective modeling study.

Researchers utilized the National Vital Statistics System’s data from 2012 to 2019 to project 2020 and 2021 mortality rates and compared projected mortality rates with observed mortality rates of individuals who died of AUD as defined by the International Classification of Diseases, Tenth Revision diagnosis codes.

From 2012 to 2021, there were 343,384 AUD-related deaths, of which 16.6% were among individuals aged 25 to 44 years; 56.0% were aged 45 to 64 years; and 27.4% were individuals aged 65 years or older. Further, 77.7% of deaths were among men. The 25 to 44 years age group had the largest increase in mortality of all groups, with 40.47% in 2020 and 33.95% in 2021.

When compared with the projected rates, the observed mortality rates increased by 24.79% in 2020 and 21.95% in 2021. These mortality rates were observed even when AUD was classified as the underlying cause of death. COVID-19 infection was attributable to less than 10.0% of all excess death.

Mortality and Hormone Replacement Therapy2

COVID-19 mortality may be reduced among women on hormone replacement therapy (HRT).

Researchers conducted a retrospective cohort study to examine the relationship between the likelihood of death and the use or HRT or combined oral contraceptive pill (COCP). Data from 465 general practices in England were utilized, from the Oxford-Royal College of General Practitioners Research and Surveillance Center. Of the 1,863,478 women in the cohort, COVID-19 infection was reported in 5451 cases.

“We found that HRT prescription within 6 months of a recorded diagnosis of COVID-19 was associated with a reduction in all-cause mortality,” researchers concluded. “Further work is needed in larger cohorts to examine the association of COCP in COVID-19, and to further investigate the hypothesis that estrogens may contribute a protective effect against COVID-19 severity.”


—Leigh Precopio



  1. Yeo YH, He X, Ting PS, et al. Evaluation of trends in alcohol use disorder-related mortality in the US before and during the COVID-19 pandemic. JAMA Netw Open. 2022;5(5):e2210259. doi:10.1001/jamanetworkopen.2022.10259
  2. Dambha-Miller H, Hinton W, Wilcox CR, Joy M, Feher M, de Lusignan S. Mortality in COVID-19 among women on hormone replacement therapy: a retrospective cohort study. Family Practice. Published online May 17, 2022. doi:10.1093/fampra/cmac041