Consumers that exceed the limit of 20–40 g/day of pure alcohol for females and 30–60 g/day for males are considered harmful drinkers (chronic heavy drinking or CHD) and have an increased risk of infections (Testino and Pellicano, 2020). Authors report a dose-dependent correlation between viral infections and alcohol consumptions in their previous study (hepatitis C) (Testino et al., 2016). Furthermore, alcohol consumption increases pneumonia according to a systematic review and a meta-analysis (Simou et al., 2018). This risk is mediated through an action on immune system, but also through an increased risk of pneumonia, malnutrition and, on a long-term basis, advanced alcohol-related liver diseases (Simou et al., 2018; Testino and Pellicano, 2020). More specifically, an early study demonstrated a correlation between alcohol consumption (for participants without alcohol use disorder) and the amount of ACE2 present in the body (in particular in the respiratory site)(Okuno et al., 1986). The ACE2 gene encodes the angiotensin-converting enzyme-2 (ACE2), which is a target receptor/enzyme for SARS-CoV2. ACE2 is a critical mediator of the renin-angiotensin system (RAS) signaling in the body and can be affected by ibuprofen or diabetes condition (Cai, 2020a).
