REVIEW article
Front. Psychiatry
Sec. Addictive Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1640207
This article is part of the Research TopicDecoding the Neuroanatomy of Addiction: Insights into Substance Use DisordersView all 4 articles
Severe Alcohol Use And Covid-19: Implications For Physical And Mental Health
Provisionally accepted
Javier Calleja-Conde1
Víctor Echeverry-Alzate2Sara Sánchez-Diez3
Elena Giné Dominguez4
Kora-Mareen Bühler5*- 1Centro de Ensenanza Superior Cardenal Cisneros, Madrid, Spain
- 2Universidad Antonio de Nebrija Facultad de Ciencias de la Vida y de la Naturaleza, Madrid, Spain
- 3Universidad Complutense de Madrid Facultad de Psicologia, Pozuelo de Alarcón, Spain
- 4Universidad Complutense de Madrid Facultad de Medicina, Madrid, Spain
- 5Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
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The COVID-19 pandemic has revealed and intensified the vulnerability of individuals with pre-existing medical and behavioral conditions, notably those related to substance use. Among these, chronic alcohol consumption represents a clinically significant, yet often under-addressed, vulnerability factor that may exacerbate both the acute severity and long-term consequences of SARS-CoV-2 infection. This narrative review examines the biological and clinical intersections between alcohol use and COVID-19, focusing on shared mechanisms of immune dysfunction, neuroinflammation, and disruption of the gut–brain axis. We synthesize current findings showing that both conditions compromise innate and adaptive immune responses, alter cytokine signaling, and weaken mucosal and blood–brain barriers. These changes contribute to cognitive and emotional dysregulation and may increase the risk of persistent neuropsychiatric symptoms, including those observed in Long COVID. In addition, we discuss how chronic alcohol use may alter host susceptibility to infection and affect the immune response to vaccination, with implications for treatment outcomes and recovery. Our findings highlight the need to integrate alcohol use disorder into COVID-19 risk assessments, clinical management, and long-term mental health care planning. A multidisciplinary approach is essential to address the overlapping biological pathways that link alcohol-related vulnerability to COVID-19 outcomes.
Keywords: COVID-19, alcohol, Immunity, Neuroinflammation, Mental Health, Long Covid
Received: 03 Jun 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Calleja-Conde, Echeverry-Alzate, Sánchez-Diez, Giné Dominguez and Bühler. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kora-Mareen Bühler, kobuhler@ucm.es
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