Soaring rates of alcohol‐related hepatitis in the latter phase of the COVID‐19 pandemic: A new normal?

Abstract

Background Studies have reported that the COVID‐19 pandemic has led to an increase in alcohol consumption and alcohol‐associated health problems in the general population. Our previous study documented a rise in severe alcohol‐related hepatitis cases requiring inpatient admission in our hospital system in the early pandemic (2019 vs. 2020). This study assesses the rates of severe alcohol‐related hepatitis in the latter part of the pandemic (2021). Methods We performed a retrospective chart review via an electronic medical record to evaluate the number of cases of alcohol‐related hepatitis in patients presenting to three community hospitals in Fresno, California, between 2019 (pre‐pandemic) and 2021. A total of 547 patients were included in the study. We compared the demographics, clinical course, and outcomes of patients with alcohol‐related hepatitis pre‐pandemic (2019), early pandemic (2020), and during the later phase of the pandemic (2021). Results The number of cases increased from 131 in 2019 to 201 in 2020 and 215 in 2021 (53% and 64% increase, respectively). The number of young patients (age <40 years) increased from 30 in 2019 to 61 in 2020 and 71 in 2021 (103% and 136% increase, respectively) ( p = 0.13). The number of admissions of women increased from 24 in 2019 to 55 in 2020 and 67 in 2021 (129% and 179% increase, respectively) ( p = 0.026). Deaths during hospitalization increased from 20 in 2019 to 26 in 2021 ( p = 0.674). The number of rehospitalizations within 3 months increased 4.5 times from 18 in 2019 to 80 in 2021 ( p < 0.001). Conclusion Our study revealed that the admissions for alcohol‐related hepatitis remained significantly above the pre‐pandemic levels through the end of 2021. We believe this sustained increase in cases of alcohol‐related hepatitis in our hospital system reflects a much larger national problem. Alcohol‐related hepatitis is associated with significant morbidity, mortality, and societal cost. Urgent public health interventions are needed at a national level to prevent this rise in cases from becoming a new normal.

Fuel to the fire: The impact of COVID‐19 on alcohol‐associated hepatitis

“…Hospitalization rates for AH increased 14.9% in women in 2020 compared to 2019, which is consistent with the reported increase in incidence and prevalence of alcohol‐related liver disease (ALD) in women (Mellinger et al, 2018). The findings by Marlowe and colleagues regarding the impact of COVID‐19 on hospitalizations for AH are similar to other published data with regard to increased prevalence of AH in patients aged less than 40 years (Sohal et al, 2023). However, the study authored by Marlowe and colleagues is likely more accurate at determining the nationwide increase in hospitalizations for AH than smaller studies, some of which estimated a 50% increase in hospitalizations for AH and ALD (Gonzalez et al, 2022; Sohal et al, 2022).…”

Mortality risk and associated factors in cirrhosis patients with SARS-CoV-2 infection

“…We also observed that elevated D-dimer levels were associated with higher mortality in the cirrhotic group 22 . Additionally, a study by Sohail et al identified chronic kidney disease, cardiovascular diseases, and intensive care admission as predictors for mortality in cirrhotic patients hospitalized with COVID-19 23 . However, other studies have found that chronic kidney disease and cardiovascular diseases were not predictors for mortality in cirrhotic patients hospitalized with COVID-19 infection 24,25 .…”

Cirrhosis with COVID‐19: Just another infection or something more to it?

“…Similarly, on multivariate analysis, the presence of COVID‐19 infection, age, Charlson's co‐morbidity index >3, acute kidney injury, end‐stage renal disease, septic shock, acute respiratory failure, mechanical ventilation, and ICU status were found to be the independent predictors of mortality. 1 …”