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Night-Shift Nurses Found to be at Greater Risk of COVID-19 Infection

Analysis  |  By Carol Davis  
   June 01, 2023

Nurses who binge-drink also multiply their risk for COVID.

Nurses who work the night shift or binge drink may double their risk of COVID-19 infection, according to a study that set out to determine why many first responders develop severe COVID despite not having associated risk factors such as obesity, diabetes, and hypertension.

The report, published in Alcohol: Clinical and Experimental Research, indicates that both night shift work—causing circadian misalignment—and alcohol misuse have been shown to affect sleep and promote inflammation in the body, which has been linked to COVID severity.

“Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce,” according to the report.

Both disruption of circadian rhythms and unhealthy alcohol use decrease resiliency to several inflammatory disorders including respiratory infection/pneumonia and acute respiratory distress syndrome—two features of severe COVID-19—the report says.

Data was gathered from American Nurses Association members who were surveyed about alcohol use, sleep patterns, experience with COVID infection and chronotype, or whether the nurse was a “night owl” or “morning person.”

Findings included:

  • Unhealthy alcohol use was associated with poor sleep quality.
  • Nurses with high-risk features for alcohol misuse and binge drinking were both more likely to work the night shift.
  • Night shift work and binge drinking were associated with an increased rate of COVID-19 infection.
  • Shift work, binge alcohol use, and high-risk features of alcohol misuse by LCA were associated with a later chronotype.

Of the 750 nurses included in the study, 25% met the criteria for alcohol misuse. The U.S. Centers for Disease Control and Prevention defines alcohol misuse as more than one drink per day on average or four or more drinks on one occasion in a month for women and men, more than two drinks per day, or drinking five or more drinks on one occasion.

Those nurses tended to be younger, were more likely to be white, and reported poorer sleep and greater stress, anger, or worry prior to sleeping, the study reveals.

To improve health outcomes in night shift workers, the report’s authors recommended further study into the mechanisms of alcohol and circadian misalignment.

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.


Night shift work and alcohol misuse affect sleep, promoting inflammation in the body, which is linked to COVID severity.

Nurses who misuse alcohol are more likely to work the night shift.

Understanding these risk factors could help mitigate the impact of COVID-19 on the healthcare workforce.

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