America Addresses Two Epidemics: Cannabis and Coronavirus and their Interactions: An Ecological Geospatial Study

Albert S Reece; Gary K Hulse

Our study set out to explore the possible ecological and geospatial associations of cannabis use and coronavirus infection with the concern that cannabis-associated immunosuppression and cannabis contamination might exacerbate the global pandemic at a time when cannabis use and particularly the intensity of cannabis use is rising dramatically in many parts of USA and abroad. Bivariate evidence supported this hypothesis by demonstrating significant associations of daily cannabis use quintile with CVIR with the highest quintile having a prevalence ratio (PR, like odds ratio) of 5.11 (95%C.I. 4.90-5.33), an attributable fraction in the exposed of 80.45% (79.61-81.25%), and an attributable fraction in the population of 77.80% (76.88-78.68%) with a trend significant at P<10 -500 . Similarly when cannabis legalization was considered decriminalization was associated with an elevated CVIR prevalence ratio of 4.51 (95%C.I. 4.45-4.58), an attributable fraction in the exposed of 77.84% (77.50-78.17%) and an attributable fraction in the population of 51.22% (50.74-51.70%) and a trend significant at P<10 -500 . When the effect was studied in a multivariable geospatial model after controlling for international travel, ethnicity, income, population, population density and drug use interactive terms in last month cannabis were significant from 7.3x10 -15 and daily cannabis use from 7.3x10 -11 . Cannabis use was independently predictive of CVIR in the final spgm model. These results strongly support the hypothesis of an ecological geospatial link between cannabis use and coronavirus infection rate.