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The Pandemic Within the Pandemic: Unprecedented Rise in Alcohol-related Hepatitis During the COVID-19 Pandemic
Aalam Sohal1, Sameeha Khalid1, Victoria Green1
1Departments of Internal Medicine.
Insights
Excessive alcohol consumption, a leading preventable cause of death, saw a significant rise in hospitalizations for alcohol-related hepatitis during the COVID-19 pandemic. This increase was particularly pronounced in younger adults and women, highlighting urgent public health needs.
Area of Science:
- Hepatology
- Public Health
- Epidemiology
Background:
- Excessive alcohol consumption is a major preventable cause of death in the U.S.
- The COVID-19 pandemic imposed significant economic and societal strains.
- Alcohol-related hepatitis is a serious condition requiring inpatient management.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on hospitalizations for alcohol-related hepatitis.
- To evaluate changes in the incidence and characteristics of alcohol-related hepatitis cases.
- To hypothesize an increase in severe cases mirroring pandemic-related societal disruptions.
Main Methods:
- Retrospective chart review of 329 patients across 3 community hospitals in Fresno, California.
- Data extraction from electronic medical records, including demographics, disease severity markers, and clinical course.
- Comparison of alcohol-related hepatitis incidence before and during the COVID-19 pandemic (2019 vs. 2020).
Main Results:
- A 51% increase in overall alcohol-related hepatitis hospitalizations occurred between 2019 and 2020 (P=0.003).
- A 69% increase was observed after stay-at-home orders (P<0.001).
- Significant increases noted in rehospitalizations (94%, P=0.028), hospitalizations in patients under 40 (100%, P=0.0028), and a trend in female patients (125%, P=0.06).
Conclusions:
- The COVID-19 pandemic led to drastic increases in severe alcohol-related hepatitis requiring hospitalization.
- Younger patients (under 40) and women were disproportionately affected.
- Urgent public health interventions are necessary to address rising alcohol misuse and its severe health consequences.
Background And Aim:
The third leading preventable cause of death in the United States is excessive alcohol consumption. Our study sought to assess the impact of the coronavirus disease 2019 (COVID-19) on hospitalizations for alcohol-related hepatitis at a community hospital system. We 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:
We performed a retrospective chart review to study the incidence of alcohol-related hepatitis in patients presenting to 3 community hospitals in Fresno, California, before and during the 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 69% increase (P<0.001) after 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 towards a 125% increase (P=0.06) of female patients admitted with this diagnosis during the COVID-19 pandemic.
Conclusions:
Our 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 our 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.
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