S1067 Alcohol-Related Liver Disease Increased in Severity During the COVID-19 Pandemic

Jain, Ayushi; Sobotka, Lindsay; Allen, Kenneth D.; McShane, Chelsey; Ramsey, Mitchell L.; Wellner, Michael; Kirkpatrick, Robert B.

doi:10.14309/01.ajg.0000777800.33890.17

Cited by 5 publications

(4 citation statements)

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“…[ 12,26 ] Given the importance of driving impairment and resultant crashes that can be potentially prevented, [ 1 ] these training sessions and data could also initiate and facilitate conversations about alcohol cessation in cirrhosis with broader implications for public health and safety. With the corona virus disease 2019 pandemic, there has been an increase in the severity and number of alcohol‐associated liver disease admissions and severity, [ 27 ] adding further relevance to this study.…”

Section: Discussionmentioning

confidence: 99%

Substance‐use simulation impairs driving capability in patients with cirrhosis regardless of hepatic encephalopathy

et al. 2022

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Driving is independently affected by cirrhosis and hepatic encephalopathy (HE) and alcohol/substance use, but their concomitant impact is unclear. We aimed to determine the impact of alcohol and other substances on drivingsimulator performance in cirrhosis with and without HE. Outpatients with cirrhosis and controls underwent cognitive testing and driving simulation for the following three conditions: baseline, wearing goggles simulating alcohol intoxication, and wearing goggles simulating opioid/benzodiazepine abuse.Outcomes were number of centerline crossings (CCs) and road-edge excursions (REEs). We compared controls versus patients with cirrhosis then subjects with cirrhosis with and without HE for all conditions, using generalized linear modeling (GLM). Sixty subjects (17 controls, 43 with cirrhosis [Model for End-Stage Liver Disease score, 10; 21 subjects with prior HE]) were included. Simulations showed higher CCs and REEs at baseline in patients with cirrhosis with and without HE versus controls. With alcohol-and substance abuse-impairment goggles, CCs increased but REEs decreased in cirrhosis. In the GLM, a time and group interaction was seen (p < 0.001) for CCs and REEs. Patients with cirrhosis showed higher CCs and REEs at baseline than controls (CCs, p = 0.003; REEs, p = 0.0001) and higher CCs (p = 0.03) and lower REEs (p = 0.001) with alcohol-simulating goggles. All groups were equally impaired with opioid/benzodiazepine-simulating goggles (CCs, p = 0.49; REEs, p = 0.46). Controls with alcohol-simulating goggles had similar CCs as the baseline of patients with cirrhosis (p = 0.98). conclusions:Simulating alcohol intake induces greater driving impairment in patients with cirrhosis versus controls, but similar patterns were seen with opioid/ benzodiazepine-simulating goggles. At baseline, patients with cirrhosis have

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Section: Discussionmentioning

confidence: 99%

Substance‐use simulation impairs driving capability in patients with cirrhosis regardless of hepatic encephalopathy

et al. 2022

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“…101 Similar trends were seen in other parts of the world, with increases in harmful alcohol consumption in China as well as increased high-risk drinking in the setting of fewer abstinence resources in England. 102,103 This trend corresponded with a rise in prevalence and severity of ALD, 104,105 resulting in significant increases in LT waitlist additions and transplants for an indication of ALD. 18,106 By the end of 2020, ALD accounted for 40.1% of all LT listings, more than HCV and nonalcoholic steatohepatitis combined.…”

Section: Antithrombotic Treatmentmentioning

confidence: 96%

COVID-19 in patients with liver disease and liver transplant: clinical implications, prevention, and management

Perreault

Ching

Nobel

2023

Therap Adv Gastroenterol

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The coronavirus disease 2019 (COVID-19) pandemic has had enormous implications for the care of patients with chronic liver disease (CLD), cirrhosis, and liver transplant (LT). Clinical outcomes of COVID-19 vary in patients with CLD and cirrhosis compared to healthy controls, and in patients with LT compared to patients without LT. Several special considerations apply to the approach to vaccination and treatment in patients with CLD and LT. The practice of liver transplantation has also been heavily impacted by the pandemic, including persistent reductions in living donor LT and increases in LT for an indication of alcohol-related liver disease. Recent medical society guidelines strive to standardize severe acute respiratory syndrome coronavirus 2 testing in donors and recipients and the approach to transplantation after recovered from COVID-19 infection, but certain controversies remain.

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“…This phenomenon from everyday life was reflected by the increasing number of ALD cases together with its more severe course all over the world (e.g., in the United States, Great Britain and China) [207]. What appeared to be especially alarming, according to available data, was that the most significant group requiring LT were young adults [208][209][210][211]. Fortunately, despite the pandemic era and a greater number of conducted transplants, 3-month post-LT recipient survival time remained at a similar level of above 96% [212].…”

Section: Ethanol Liver and Covid-19-a Global Perspectivementioning

confidence: 99%

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

Michalak,

Lach,

Szczygieł

et al. 2024

IJMS

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The pandemic period due to coronavirus disease 2019 (COVID-19) revolutionized all possible areas of global health. Significant consequences were also related to diverse extrapulmonary manifestations of this pathology. The liver was found to be a relatively common organ, beyond the respiratory tract, affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Multiple studies revealed the essential role of chronic liver disease (CLD) in the general outcome of coronavirus infection. Present concerns in this field are related to the direct hepatic consequences caused by COVID-19 and pre-existing liver disorders as risk factors for the severe course of the infection. Which mechanism has a key role in this phenomenon—previously existing hepatic disorder or acute liver failure due to SARS-CoV-2—is still not fully clarified. Alcoholic liver disease (ALD) constitutes another not fully elucidated context of coronavirus infection. Should the toxic effects of ethanol or already developed liver cirrhosis and its consequences be perceived as a causative or triggering factor of hepatic impairment in COVID-19 patients? In the face of these discrepancies, we decided to summarize the role of the liver in the whole picture of coronavirus infection, paying special attention to ALD and focusing on the pathological pathways related to COVID-19, ethanol toxicity and liver cirrhosis.

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S1067 Alcohol-Related Liver Disease Increased in Severity During the COVID-19 Pandemic

Cited by 5 publications

References 0 publications

Substance‐use simulation impairs driving capability in patients with cirrhosis regardless of hepatic encephalopathy

Substance‐use simulation impairs driving capability in patients with cirrhosis regardless of hepatic encephalopathy

COVID-19 in patients with liver disease and liver transplant: clinical implications, prevention, and management

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

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