Alcohol misuse during COVID-19 may contribute to increased need for liver transplants
Click Here to Manage Email Alerts
Waiting list registrations and deceased donor liver transplantations for alcoholic hepatitis increased significantly during the COVID-19 pandemic compared with earlier trends, according to data published in JAMA Network Open.
“Alcohol consumption has substantially increased during the COVID-19 pandemic; however, the impact on the already increasing burden of alcohol-associated liver disease (ALD) is unknown,” Maia S. Anderson, MD, and colleagues at the University of Michigan wrote. “We examined national changes in waiting list registration and liver transplantation for ALD and the association with alcohol sales during the COVID-19 pandemic.”
In the cross-sectional study, new waiting list registrations, primary deceased donor liver transplants (DDLTs) and national monthly retail alcohol sales between Jan. 1, 2016, and Jan. 31, 2021, in the U.S. were evaluated. The pre-pandemic time frame was defined as the period between March 2019 and January 2020, and the pandemic time frame was defined as the period between March 2020 and January 2021. Transplant categories were alcoholic hepatitis (AH), alcohol-related cirrhosis (AC) or non-ALD.
In the current research letter, Anderson and colleagues report a total of 51,488 new waiting list registrants and 32,320 DDLTs from Jan 1, 2016, to Jan 31, 2021. The median age of waiting list registrants and liver transplant recipients was 58 years before and during COVID-19. Among new waiting list registrants, 36.1% were women and 63.9% were men pre-pandemic, and 37.3% were women and 62.7% were men during the COVID-19 study period (P = .03).
There was a statistically significant increase in the proportion of waiting list registrations in the COVID-19 time frame vs. the pre-pandemic time frame: 227 of 9,311 registrations (2.4%) vs. 138 of 9,638 registrations (1.4%); P < .001. Similarly, there was a statistically significant increase in DDLTs for AH: 185 of 6,162 (3%) vs. 103 of 6,263 (1.6%); P < .001.
The researchers found a temporal association and positive correlations between increasing retail alcohol sales and increasing waiting list registrations and increasing DDLTs for AH (both P < .001). However, the trends for AC and non-ALD did not change during COVID-19.
“Several studies have now shown that alcohol consumption rates increased during the pandemic. Our results show that the downstream effects of heavy alcohol use appeared in the form of increased waitlist additions and transplants for acute alcoholic hepatitis during the pandemic,” Jessica Mellinger, MD MSc, co-author on the study, told Healio. “However, it remains to be seen if these increased trends are here to stay, as some evidence suggests that alcohol consumption has remained above pre-pandemic levels. Much more work is needed to devise public health strategies to combat rising alcohol use and ALD rates.”
Collapse
Read more about
Click Here to Manage Email Alerts