Washington State University
A boom in alcohol sales during the pandemic appears to have had dire consequences for some, as hospital admissions for alcohol-related hepatitis , a life-threatening inflammation of the liver, rose sharply, according to a study of national hospitalization data.
Researchers found an increase in cases of alcohol-related liver disease from 2016 to 2020, but the increase was particularly pronounced the year COVID-19 arrived in the U.S. It was worse in younger patients, ages 18 to 44 years old, a group that had an almost 20% increase in hospital admissions for alcohol-related hepatitis. The consequences were also more serious, with hospital deaths increasing by 24.6% in 2020 compared to 2019.
While the problem has been noted anecdotally and in regional studies, these findings show the growing problem on a national scale, said Dr. Kris Kowdley, a professor at Washington State University Elson S. Floyd School of Medicine and author main of the study.
"Severe liver disease appears to be increasing over time, but appears to have increased even more dramatically during the pandemic," said Kowdley, who is also director of the Northwest Liver Institute. "We confirmed that hospital admissions for alcohol-related hepatitis increased continuously from 2016 to 2020. We also found that younger patients and women had a greater increase in hospital mortality compared to their counterparts."
Alcohol-related hepatitis typically affects about one-third of heavy drinkers, those who consume more than four alcoholic drinks a day. Symptoms may include abdominal pain, loss of appetite, vomiting, and jaundice. The disease can cause permanent liver damage, known as cirrhosis, and death.
Drawing on data from the National Inpatient Sample, which tracks hospitalization in 37 states, the study found that about 823,000 patients were hospitalized with the condition between 2016 and 2020, the most recent year for which data was available. While this is a relatively small group compared to the US population, researchers are concerned about the rapid increase in cases and the severity of the outcomes.
In 2016, about 146,000 patients were admitted to hospital with alcohol-related hepatitis. In 2019, the number rose to almost 169,000, representing a 5.1% annual increase over 2016 levels. It then rose even more rapidly to more than 190,000 in 2020, a 12.4% increase with compared to 2019 levels.
Figure : Number of hospitalizations for alcohol-related hepatitis (ARH) from 2016 to 2020.
While the condition is more common in men overall, women saw a greater increase, an increase of 14.6% between 2019 and 2020 compared to men at 12.2%. Geographically, more cases were seen in the southern US, but the largest increase was in the west.
There was also a change in economic status. Looking at income by four groups or quartiles, the researchers found that between 2016 and 2019, the two highest income groups had the largest increase in alcohol-related hepatitis. By 2020, that had changed, with the lowest-income group showing the largest increase in cases .
"A variety of factors likely contributed to a much higher rate of alcohol use during the pandemic, such as being socially isolated and having fewer barriers to binge drinking," Kowdley said. "It is also very possible that the relationship with lower income may be related to the stress, anxiety and financial worries associated with the pandemic."
Kowdley said the findings show the need for a multidisciplinary approach to treating people suffering from alcohol use disorders, one that includes mental health and behavioral therapy, nutritional counseling and increased use of medications that help reduce cravings. alcohol. It is also important to reduce the stigma associated with alcohol-related liver disease.
"We need to recognize and treat alcohol-related hepatitis as a disease like any other disease, and not stigmatize the patient suffering from this disease," he said. "We must also be aware, both as healthcare providers and patients, that alcohol-related hepatitis can be a life-threatening disorder."
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Reference : Number of hospitalizations for alcohol-related hepatitis (ARH) from 2016 to 2020. The American Journal of the Medical Sciences (2023). DOI: 10.1016/j.amjms.2023.06.002
