Higher Alcohol Consumption Is Not Linked To Higher SARS CoVid19 Infection and Death

Background Severe acute respiratory syndrome (SARS) corona virus mediated CoVid19 (corona virus disease 19) pandemic is a global concern. At the present, almost all countries of the world are home to the CoVid19 infection with varying rate. Methodology To understand the role of alcohol consumption and rate of CoVid19 infection, we conducted a comparative statistical analysis using the top CoVid19 infected countries of the world and compared them with per capita alcohol consumption per year. In addition, a Google trend analysis was conducted to understand the sentiments of the people towards the search of alcohol. Results We found that higher alcohol consumption is not proportional to the higher number of CoVid19 infection and deaths. Google trend analysis for search of alcohol for last 12 months was found highest for Australia followed by New Zealand, Ireland, United States, and South Africa, suggesting sentiment of higher alcohol search also not related to the SARS CoV-2 infection and deaths.


Background
Corona virus mediated severe acute respiratory syndrome (SARS) caused by SARS CoV-2 (CoVid19) is a global pandemic [1][2][3] and at the present it has infected more than 3.9 million people and claimed 270000 (7%) deaths world-wide. There are several misconceptions regarding the alcohol consumption and prophylaxis against corona virus as alcohol might kill the virus in the stomach. However, excessive or frequent drinking of alcohol weakens the immune system and it might get easier to get sick at this critical moment of the life [4][5][6]. Due to the lock down of several cities, people feeling anxiety and boredom in stay-at-home condition which led to the increase in alcohol consumption. Drinking alcohol in short-run can also supress the optimal function of the immune system. People who are drinking for decades and infected with respiratory tract infection require mechanical ventilation as well. Therefore, we tried to understand whether drinking more alcohol linked to the higher rate of CoVid19 infection across the globe.

Results
The major suffered countries due to CoVid19 are Italy, the United States of America (USA), Spain, France, the United Kingdom (UK), and Germany with 215858, 1279391, 256855, 174791, 206715, and 169015 infections, respectively (till 7th May 2020). The number of deaths in Italy, the United States of America (USA), Spain, France, the United Kingdom (UK), and Germany were 29958, 76928, 26070, 25987, 30615, and 7392, respectively. Nobody knows when the pandemic will come to an end. According to the 2016 report by world health organization (WHO), the UK ranked 4th (12 liters), France 5th (11.6 liters), Spain 10th (10.6 liters), USA ranked 14th in terms of annual alcohol consumption. Therefore, we analysed CoVid19 related deaths of top 21 countries and compared with the annual alcohol consumption. The correlation analysis of alcohol consumption and death rate has correlation coe cient of 0.003236 ( Fig. 1, Table 1). Therefore, the annual alcohol consumption with regard to CoVid19 mediated death was not related. The rank of per capita annual alcohol consumption of the UK (12 liters/year), France (11.6 liters/year), Belgium (10.8 liters/year), Germany (10.6 liters/year), Spain (10.6 liters/year), USA (9 liters/year), and Italy (6.1 liters/year) was 4th, 5th, 8th, 9th, 10th, 14th, and 20th, respectively. Although, USA ranked 14th and Italy ranked 20th in the annual alcohol consumption, the CoVid19 mediated death was quite higher in the USA (76928) and Italy (29958). However, the percentage of death rate in the USA and Italy was 5.95% and 13.87%, respectively. Belgium ranked 8th in the annual alcohol consumption and it was observed highest death rate of 16.36%. The death rate was followed by France (14.86%) and the United Kingdom (14.81%). Although Italy ranked 20th in the global alcohol consumption, the mortality rate in the Italy was 13.87%. the highest infected population was found in the USA (1.29 million) followed by Spain (256855) and Italy (215858). A correlation regression analysis of annual alcohol consumption with regard to number of infections was also not correlated. The correlation coe cient for annual alcohol consumption and infection was − 0.0792 (Fig. 2, Table 1). Therefore, it was concluded that annual alcohol consumption is not related higher CoVid19 infection or death rate.

Discussion
Although, CoVid19 pandemic led to suffered the whole world, it is more prone in the countries belonged to the European Union (EU) and the United States of America. It is well known that the hygiene, cleanliness, medical facility and living standard of these mentioned countries are quite higher compared to other nations [7][8][9]. Still these countries have witnessed a greater rate of deaths due to CoVid19. Recently, Clay and Parker (2020) has mentioned alcohol misuse contribute approximately 3 million deaths world-wide and the alcohol consumption rate in the USA and other EU countries are quite higher compared to the Asian countries [10,11]. Therefore, question raised whether there is a relation between higher alcohol consumption leading to reduced immunity and CoVid19 mediated deaths in these countries. But, the CoVid19 mediated infection and death was not related. Similarly, due to the lockdown of the major cities and shops, peoples did not able to avail the one of the popular drink "alcohol". The lack of free access of alcohol certainly raised the feelings towards online search of alcohol and hence people tried to nd the alcohol selling centre through Google search. Australia was top the search trend in the Google followed by New Zealand and Ireland.

Conclusion
The countries associated with higher per capita alcohol consumption do not show higher CoVid19 related infection and subsequent death. Alcohol has no direct linked with higher CoVid19 infection.

Materials And Methods
The CoVid19 details were collected from the CoVid visualizer (https://www.covidvisualizer.com/) hosted by Worldometer that collects the real-time CoVid19 data. The per capita alcohol consumption rate was collected from world health organization (WHO). The data were analysed using statistical software Past3. Ordinary least square correlation (p < 0.05) study was conducted to nd the correlation between the (i) alcohol consumption and number of CoVid19 infection and (ii) alcohol consumption and death rate (%). The current trends of alcohol search term in internet was accessed using the Google trends platform. The highest searched country in Google is marked as 100. All the studied data were taken from publicly available database and data associated with the manuscript is provided in supplementary le.

Competing of interest
There is no competing of interest to declare.
Author contribution YKM: drafted and revised the manuscript, AH: revised the manuscript, EFA: revised the manuscript, TKM: conceived the idea, analysed the data, drafted the manuscript.

Funding
Not applicable Figure 1 Correlation analysis of annual alcohol consumption and CoVid19 mediated death in the countries with more than 5000 deaths. The CoVid19 mediated death data collected till 7th May 2020. The data was collected from COVID-19 visualizer (https://www.covidvisualizer.com/).