The impact of COVID-19 on alcohol-associated hepatitis and alcohol-associated cirrhosis

During the COVID-19 pandemic, there was an increase in alcohol consumption. Here, we investigated COVID-19's impact on alcohol-associated hepatitis (AH) and alcohol-associated cirrhosis (AC) outcomes.

Data from HCA's Enterprise Data Warehouse were examined (1/1/18 - 12/31/22). Patients aged > 18 years admitted for AH or AC were included. Pre- COVID-19 (2018-2019) and COVID-19 (2021-2022) time frames were evaluated. Statistical analyses were performed to evaluate LOS, discharge disposition, and mortality.

Of the 3177 patients with AH and AC, 1752 were admitted during COVID-19 (AH: 815, AC: 937). Patients in both groups were predominantly male (AH: 68%, AC: 72%) and White (AH: 73%, AC: 79%), with patients in the AH group being younger than those in the AC group (49 vs. 56 years). During COVID-19, 369/815 (45%) patients in the AH group and 447/937 (48%) patients in the AC group were diagnosed with COVID-19. In patients with AH, those diagnosed with COVID-19 had a 2.4-day longer LOS (OR: 2.36, p < 0.001), a 39% decreased likelihood of home discharge (OR: 0.61, p < 0.05), and a 223% increase in mortality (OR: 2.23, p < 0.05), compared to patients with AH, but without COVID-19. In patients with AC, those with COVID-19 had a 2.2-day longer LOS (OR: 2.19, p < 0.001), though discharge disposition and mortality were not significantly affected by a COVID-19 diagnosis.

Patients with COVID-19 and AH or AC had longer LOS. Mortality was increased in AH but not AC, perhaps reflecting greater acuity and severity of AH than AC.