The Impact of COVID-19 on Alcohol-related Morbidity and Mortality: A Multicenter Study

During the COVID-19 pandemic, there was a rise in alcohol (ethanol) use nationwide. In this study, we investigated the effect of COVID-19 on alcohol-related hospital outcomes.

Deidentified claims data spanning 2018 through 2022 from HCA's Enterprise Data Warehouse (South Atlantic Division) were examined. The population included adults aged >18 years who had an encounter at an HCA facility and a diagnosis of alcohol use disorder or alcohol-related illnesses. Two time frames were evaluated: 2018-2019 (pre- COVID-19) and 2021-2022 (COVID-19). Statistical analyses were performed to evaluate LOS, home discharge, and mortality.

Of the 72,575 patients (26,678 during the COVID-19 time period and 35,897 from 2018 to 19) meeting inclusion criteria for alcohol use and alcohol-related illness, the majority were male, had an average age of 50-years-old, and were predominantly White. Among the 26,678 COVID-19 patient admissions (2021-2022), 12,735 (35 %) were diagnosed with COVID-19 (p < 0.001). During the COVID-19 period, there was a 36 % increase in mortality, 2 % fewer discharges home, and a half day increase in average LOS (vs pre-COVID-19 period; all p < 0.001). In multivariable regression, patients who tested positive for COVID-19 had a 3-day longer length of stay, a 60 % lower likelihood of discharge to home, and a 284 % higher inpatient mortality rate compared to COVID-negative patients (all p < 0.001).

Patients diagnosed with COVID-19 and alcohol-related morbidity had longer LOS, fewer discharges home, and higher mortality. Together, the data suggest that COVID-19 is associated with increased morbidity in patients with an alcohol-related illness.