Increased alcohol-related liver disease diagnoses amid SARS-CoV-2
Researchers reported a significant increase in alcohol-related liver disease diagnoses amid the SARS-CoV-2 pandemic, according to a presentation at Digestive Disease Week.
“There has been a reported changing prevalence of non–COVID-19 diseases during this pandemic,” Travis Roark, MD, Scripps Green Hospital in San Diego, Calif., and colleagues wrote. “There is concern mental health disorders have been exacerbated as people are socially isolated and dealing with profound stressors, leading to behaviors like increased alcohol consumption.”
Using the Scripps Health electronic medical record Epic SlicerDicer, researchers performed a retrospective analysis of alcohol-related diagnoses and hospital trends from January 2019 through December 2020. They further compared alcohol-related diagnoses vs. non-alcohol related diagnoses and correlated the data to SARS-CoV-2 cases and trends in national alcohol sales.
According to study results, monthly alcohol-related liver disease cases increased by 33.4% from August 2020 to December 2020. Alcohol-related pancreatitis cases and alcohol-related neuropsychiatric hospital admissions also increased by 36.5% from June 2020 to December 2020 and by 20.4% from September 2020 to December 2020, respectively. Researchers did not observe increased non-alcoholic liver disease diagnoses. They further noted an increase in alcohol sales by $2 billion per month.
“I don't think that it was a surprise to anyone that there was an increase in harmful alcohol use during the COVID-19 pandemic. And what appears to be the primary driver behind this increase in harmful alcohol consumption seems to be related to social isolation,” Roark said. “My hope is going forward that we will be able to use what we've learned in the course of this pandemic to be better advocates for our patients as well as to have better understanding to deal with healthcare crises or pandemics that put patients in positions of social isolation.”
Perspective
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The Scripps group noted that there was a significant increase in alcohol-related liver disease cases that occurred as the pandemic progressed from the late summer to December 2020. They also noted, in addition to alcohol-related liver disease, there were a variety of other alcohol-related comorbidities that increased in volume (ie, neuropsychiatric disorders and alcoholic pancreatitis).
These results arise from what has been observed throughout the U.S. during the pandemic; that is, increased alcohol sales, and it is to be expected that increased alcohol consumption has led to increased cases of alcohol associated disease cases and comorbidities both in the hospital and in outpatient encounters. As we emerge from the pandemic, it will be important to devote resources to ensure those with alcohol associated diseases can be engaged in care and be provided the support they require.
This study was also nicely complemented by Chung’s presentation, which also noted, similar to the increase in alcohol associated liver disease cases, that consults on alcohol-related GI and liver disease — particularly alcoholic hepatitis — increased by over 50% during the lockdown and has remained elevated. This trend is something we will have to monitor as we continue to emerge from shelter, and hopefully recalibrate to a more typical level of alcohol-associated liver disease consults. Time will tell whether this now is going to be the new normal for the contribution of alcohol-associated liver disease as well as other types of liver disease consults we see.
Both these presentations reflect that the pandemic drove an increase in alcohol consumption and this alcohol consumption is now reflected in an increased burden of alcohol-associated liver disease that our gastroenterology and hepatology colleagues are now seeing across the country.
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Roark T, et al. Abstract 11. Presented at: Digestive Disease Week; May 21-23, 2021 (virtual meeting).