to describe the evolution of anxiety during the COVID-19 pandemic in France and to assess whether it differed according to pre-existing alcohol misuse.

A prospective longitudinal study.

A French online cohort: CONFINS. Data has been collected since the first lockdown in April–May 2020 until January 2022.

1868 participants being at least 18 years of age and who had been confined in France by government measures.

The primary outcome was anxiety, measured through Generalised Anxiety Disorder – seven items (GAD-7). Its association with alcohol misuse (defined using AUDIT-C score) was estimated using segmented linear mixed models. Interactions with gender and perceived loneliness at baseline were evaluated.

Of the 1868 included participants, 729 responded to at least one follow-up questionnaire (median follow-up time: 46 weeks). We identified 58% as having pre-existing alcohol misuse. Alcohol misuse was significantly associated with an increased GAD-7 score starting at the second lockdown in women (β=0.30; p=0.014) and in participants having a high perceived loneliness (β=0.59; p=0.011).

Pre-existing alcohol misuse appeared to be a risk factor for anxiety during the COVID-19 pandemic, particularly for women and those with high perceived loneliness. Mental health support should be proposed to these vulnerable groups in the event of a future health crisis.