Surges in alcohol purchases and use during the pandemic drove up hospital admissions for alcoholic hepatitis, and there may be a negative impact on alcoholic liver disease in the future, researchers from Canada reported.
An average of 69.5 patients with alcoholic hepatitis required hospitalization in the period after April 2020 — the initial lockdown time in Alberta, Canada — versus an average of 39.6 hospitalizations in the comparative period (2018-2020), for a difference that was statistically significant (P<0.001), according to Abdel-Aziz Shaheen, MBChB, of the University of Calgary.
However, there was no similar spike in monthly admission rates for patients with non-alcoholic cirrhosis or with alcohol-related cirrhosis, he said during a press conference at the European Association for the Study of the Liver virtual meeting.
“Our results actually show that an increase in alcohol sales post-pandemic will impact significantly the natural history of alcohol liver disease in Canada and probably most of the Western world,” Shaheen noted.
He explained that in-hospital patients with alcoholic hepatitis during the pandemic tended to be younger (age 43 vs 47 pre-pandemic), although there were no significant differences in admission outcomes pre- and post-pandemic in that group.
Shaheen and colleagues identified liver-related hospitalizations for non-alcoholic cirrhosis, alcoholic cirrhosis, and alcoholic hepatitis in the province of Alberta, Canada through 2018-2020. They looked at health records for >4 million Alberta residents in the national health system, and identified 2,916 hospitalizations for non-alcoholic cirrhosis, 2,318 hospitalizations for alcoholic cirrhosis, and 1,408 alcoholic hepatitis hospitalizations during the study time.
“The striking and alarming [result] we found…was a 9% increase on monthly average for alcoholic hepatitis admission post-epidemic,” Shaheen stated. “That means, month after month after March 2020, we found an increase in admissions for alcoholic hepatitis,” and they determined that April 2020 was the inflection point.
He noted that ICU admission for those with end-stage liver disease patients did not change post-pandemic, and that for non-alcoholic cirrhosis, mortality rates among non-alcoholic cirrhosis patients post-pandemic went down from 11.5% to 8.5%.
David Bernstein, MD, of the Sandra Atlas Bass Center for Liver Diseases at Northwell Health in Manhasset, New York, told MedPage Today that the study was “very important…These rates seen in Canada are similar to the increased rates of hospital admissions for alcoholic hepatitis currently being seen in the U.S.”
“The COVID pandemic led to an increase in alcohol sales, as alcohol remained available during quarantine, as liquor stores were deemed essential throughout the United States,” explained Bernstein, who was not involved in the study. “As many of these admissions for alcoholic hepatitis were, and continue to be, in young patients, the overall effect of the COVID pandemic on the increased intake of alcohol remains to be determined.”
He said he agreed with the authors that “the future impact of the surge in alcohol consumption during the pandemic could have severe and detrimental consequences.”
Shaheen disclosed no relationships with industry.
Bernstein disclosed relationships with Gilead.