Alcohol-associated liver disease mortality on rise, surged during pandemic
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Alcohol-associated liver disease mortality rates increased each year from 2017 to 2020 and accelerated during the COVID-19 pandemic, according to data published in Clinical Gastroenterology and Hepatology.
“We have witnessed a persistent increase in mortality for over two decades now and have seen an acceleration in this trend since the onset of the COVID-19 pandemic,” Sasha Deutsch-Link, MD, a gastroenterology fellow at the University of North Carolina School of
Medicine, and colleagues told Healio. “Coupled with increasing alcohol consumption that began during the COVID-19 pandemic, this portends a continued rise in alcohol-associated liver disease burden and mortality.”
To further investigate trends in alcohol-associated liver disease (ALD) mortality rates, Deutsch-Link and colleagues used the Underlying Cause of Death public-use data file from the CDC National Center for Health Statistics to collect mortality data on U.S. residents from Jan. 1, 2017, to Dec. 31, 2020. They reported annual age-adjusted mortality rates by sex and race/ethnicity, as well as monthly percent change in crude mortality, using the National Cancer Institute’s Joinpoint Regression Program.
According to investigators, the monthly percent change of crude ALD-related mortality counts among men was 0.36 (95% CI, 0.21-0.51) before February 2020 and 3.18 (95% CI 2.2-4.17) after February 2020, which corresponds to an average monthly percent change from January 2017 through December 2020 of 0.96 (95% CI, 0.73-1.19).
For women, the monthly percent change was 0.46 (95% CI, 0.28-0.64) before February 2020 and 3.8 (95% CI, 2.7-5.07) after February 2020, which corresponds to an average of 1.18 (95% CI, 0.9-1.46) from January 2017 through December 2020.
“These mortality rates have accelerated since early 2020, right around the beginning of the COVID-19 pandemic,” Deutsch-Link told Healio, explaining that from 2019 to 2020, ALD rates increased 51% in men aged 25 to 34 years and 45% in men aged 45 to 54, and in women, this increase was 38% for ages 25 to 34 years and 47% for ages 35 to 44.
According to investigators, factors that may have contributed to the rise of ALD during the pandemic include compromised appropriate health care, as well as rising obesity/metabolic syndrome and comorbid non-alcoholic fatty liver disease, both of which can increase the risk for ALD. They also noted that ALD mortality rates are increasing not only among both sexes at nearly every age, but also among all ethnic and racial demographics.
“Future studies should focus on interventions to address alcohol use on a public health level and improve access to evidence-based treatment for alcohol-use disorder,” Deutsch-Link said. “We have witnessed several successful interventions to address the opioid crisis, and we need to learn from these efforts to intervene on the rise in alcohol consumption and its associated complications.”
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