The University of Miami Institutional Review Board approved the study

Therefore, the objectives of the study were to determine the suitable LED combination for the higher accumulation of medicinal cannabinoids and select the stress markers of cannabis plants under light-mediated stress conditions.It is well accepted in the literature that heavy alcohol usage has been associated with multiple pathologies, ranging from gastrointestinal and renal toxicity to neurological dysfunction . The evidence supporting a relationship between alcohol abuse and more severe pulmonary disease is also documented in the medical literature . Susceptibility to pulmonary infection has been associated with alcohol use, as incidence of both communityacquired and hospital-acquired pneumonias have been observed to be more common among those who abuse alcohol.

Alcohol abuse is also associated with pneumonia outcomes, including longer recovery times, more severe bacteremia, and increased mortality . Further evidence suggests that the severity of ARDS and pneumonia is greatly increased in those who have a history of alcohol and polysubstance abuse . Cannabis use has also been associated with pulmonary dysfunction, such as wheezing, shortness of breath, and cough . However, restrictions on the study of controlled substances and challenges in study design have resulted in conflicting evidence of a causative relationship between cannabis use and frank pulmonary disease . Similar to pathologies associated with alcohol abuse, cannabis abuse is associated with various pulmonary pathologies such as bronchial damage, basal cell hyperplasia, and increased frequency and severity of asthma exacerbations . The practice of consuming alcohol and cannabis simultaneously, colloquially known as “crossfading”, is known to be common among cannabis users, and has only recently been a target of investigation . Recent study into the effect of simultaneous cannabis and alcohol consumption suggests that cannabis modulates the pulmonary inflammatory effects of alcohol via toll-like receptors that sense pathogens and initiate inflammatory responses .

Despite these published findings, many states have legalized medicinal and recreational cannabis usage, highlighting the need to understand the effects of simultaneous alcohol and cannabis usage . The novel coronavirus SARS-CoV-2 has presented as a highly communicable respiratory virus and the causative agent for the lethal pulmonary disease known as COVID-19. SARS-CoV-2 can easily be transmitted between people in close proximity through respiratory droplets or microscopic aerosolized particles. As of 1 March 2021, over 2.5 million fatalities associated with COVID-19 have occurred throughout the world, with the majority occurring in the United States, India, Brazil, Russia, and Western Europe . While severe pathology and disease initially was thought to primarily affect older adults with various pre-existing health comorbidities, otherwise healthy individuals have also died from the disease, and the determinants of susceptibility are still being investigated. These data suggest that environmental and social factors such as substance use may contribute to the susceptibility to severe disease among those infected with SARS-CoV2. It is concerning that as the SARS CoV-2 pandemic continues to spread, excessive alcohol and cannabis consumption, possibly associated with the stress of isolation, quarantine and social distancing, may increase the risk of severe COVID-19 disease. The aim of this study is to evaluate risk factors associated with alcohol and cannabis consumption that may contribute to worsened COVID-19 disease prognosis and hospitalization.

Our data suggest that alcohol and cannabis use may contribute to synergistic priming of more severe inflflammation within the lung, in the setting of a pulmonary infection, and further investigation in humans may be warranted. Our findings using in vivo mouse models, the clinical literature, and population-based data all support the hypothesis that consumption of alcohol is associated with contracting pneumonia and experiencing protracted illness. The observed increase in alcohol and cannabis sales during the pandemic may constitute a risk factor for contracting SARS-CoV2 infection, or severe disease. Though the increased purchase and consumption of substances were likely coping strategies against the isolation and stress associated with the pandemic, the unappreciated effects upon pulmonary health are a real risk. It is of great concern that as our population attempted to minimize their likelihood of contracting COVID-19 by isolating and distancing, they may have been consuming compounds that may increase their vulnerability to severe disease.