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Pandemic triggers surge in severe alcohol-induced liver damage


Newswise — SEATTLE, Wash. –A study analyzing national hospitalization data has revealed alarming consequences of the surge in alcohol sales during the pandemic. The research indicated a significant rise in hospital admissions for alcohol-related hepatitis, a life-threatening liver inflammation. While cases of this liver illness had been increasing from 2016 to 2020, the impact was particularly severe in 2020, the year COVID-19 arrived in the United States. Compared to 2019, there was a staggering 12.4% overall increase in hospital admissions, with a particularly alarming 20% rise among younger patients aged 18 to 44. The consequences were dire, as in-hospital deaths increased by 24.6% in 2020 compared to the previous year.

Dr. Kris Kowdley, a professor at Washington State University’s Elson S. Floyd College of Medicine and the senior author of the study published in the American Journal of the Medical Sciences, highlighted the significance of these findings. He noted that while the problem had been observed anecdotally and in regional studies, this research demonstrates the growing issue on a national scale. Dr. Kowdley, who is also the director of the Liver Institute Northwest, expressed concern about the escalating severity of liver disease, particularly during the pandemic. Additionally, the study revealed that younger patients and women experienced a higher increase in in-hospital mortality compared to other groups.

Alcohol-related hepatitis is commonly observed in heavy, regular drinkers, typically accounting for approximately one third of individuals who consume more than four alcoholic beverages daily. Symptoms of this condition include abdominal pain, loss of appetite, vomiting, and jaundice. If left untreated, it can lead to irreversible liver damage known as cirrhosis and may even result in death.

A study based on data from the National Inpatient Sample, which monitors hospitalizations in 37 states, examined the hospitalization rates between 2016 and 2020, the most recent year for available data. The study identified approximately 823,000 patients who were admitted to hospitals due to alcohol-related hepatitis during this period. Although this number represents a relatively small proportion of the overall U.S. population, researchers are concerned about the rapid escalation of cases and the severity of outcomes associated with the condition.

In 2016, around 146,000 patients were hospitalized with alcohol-related hepatitis. By 2019, this figure had risen to nearly 169,000, indicating an annual increase of 5.1% compared to the 2016 levels. However, the number of hospitalizations surged even more rapidly in 2020, surpassing 190,000 cases, which represents a substantial 12.4% increase from the previous year.

Although alcohol-related hepatitis is more prevalent among men, the study observed a greater increase in cases among women. Between 2019 and 2020, there was a 14.6% rise in hospital admissions for women, while men experienced a 12.2% increase. Geographically, the Southern region of the United States recorded a higher number of cases overall, but the most significant surge was observed in the Western region.
A notable shift in economic status was also observed in relation to alcohol-related hepatitis. Analyzing income levels divided into four quartiles, researchers discovered that between 2016 and 2019, the top two income groups experienced the highest increase in cases. However, by 2020, this trend had changed, and the lowest income group exhibited the largest rise in alcohol-related hepatitis cases.

Dr. Kowdley noted that various factors likely contributed to the higher rate of alcohol consumption during the pandemic, including social isolation and fewer barriers to excessive drinking. Additionally, the association between lower income and increased cases may be attributed to the stress, anxiety, and financial concerns brought about by the pandemic.

The findings underscore the necessity of a comprehensive, multi-disciplinary approach to address alcohol use disorders. This approach should incorporate mental health and behavioral therapy, nutritional counseling, and an increased utilization of medications that aid in reducing alcohol cravings. Moreover, it is crucial to combat the stigma associated with alcohol-related liver disease.

“We must recognize alcohol-related hepatitis as a legitimate disease and avoid stigmatizing patients suffering from this illness,” emphasized Dr. Kowdley. “Healthcare providers and patients alike should be aware that alcohol-related hepatitis can be a life-threatening disorder and should be treated accordingly.”

In addition to Kowdley, study authors include Dr. Aalam Sohal from the Liver Institute Northwest; Dr. Jay Patel of Orange Park Medical Centre; Nimrat Dhillon of Sri Guru Ram Das Institute of Medical Sciences; Isha Kohli of Mount Sinai; Dino Dukovic of Ross University and Dr. Hunza Chaudry and Dr. Marina Roytman both of the University of California, San Francisco.


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