Unprecedented Rise in Alcohol-related Hepatitis During the COVID-19 Pandemic
Abstract
Background and Aim
The third leading preventable cause of death in the United States is excessive alcohol consumption. This study sought to assess the impact of the coronavirus disease 2019 (COVID-19) on hospitalizations for alcohol-related hepatitis in a community hospital system. The researchers hypothesized an increase in cases of alcohol-related hepatitis requiring inpatient management, mirroring the strain on economic and societal norms imposed by the COVID-19 pandemic.
Approach/Results
The researchers performed a retrospective chart review to study the incidence of alcohol-related hepatitis in patients presenting to three community hospitals in Fresno, California, before and during COVID-19. Data including patient demographics, markers of disease severity, and clinical course were extracted from electronic medical records for 329 patients included in the study. There was a 51% increase in the overall incidence of alcohol-related hepatitis requiring hospitalization between 2019 and 2020 (P=0.003) and a 69% increase (P<0.001) after the implementation of the stay-at-home orders. In addition, 94% (P=0.028) increase in rehospitalizations was noted in 2020 (P=0.028), a 100% increase in patients under the age of 40 (P=0.0028), as well as a trend toward a 125% increase (P=0.06) of female patients admitted with this diagnosis during the COVID-19 pandemic.
Conclusions
This study revealed drastic increases in severe alcohol-related hepatitis requiring inpatient management, specifically in patients under the age of 40 and in women during the COVID-19 pandemic. Given the high morbidity and mortality associated with severe alcohol-related hepatitis, these findings have far-reaching and lasting implications for the already strained health care system extending beyond the COVID-19 pandemic timeframe. Urgent public health interventions are needed to combat the rising misuse of alcohol and its consequences.
