Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2023; 15(2): 282-288
Published online Feb 27, 2023. doi: 10.4254/wjh.v15.i2.282
Hospitalizations for alcoholic liver disease during the COVID-19 pandemic increased more for women, especially young women, compared to men
John Patterson Campbell, Vinay Jahagirdar, Adel Muhanna, Kevin F Kennedy, John H Helzberg
John Patterson Campbell, Adel Muhanna, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas City, Kansas City, MO 64111, United States
Vinay Jahagirdar, Department of Internal Medicine, Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas City, Kansas City, MO 64111, United States
Kevin F Kennedy, Division of Cardiology, Saint Luke’s Health System of Kansas City, Kansas City, MO 64111, United States
John H Helzberg, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Liver Disease Management Unit, Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas City, Kansas City, MO 64111, United States
Author contributions: Campbell JP, Jahagirdar V, Muhanna A, Kennedy KF, and Helzberg JH contributed equally to this work; Campbell JP contributed to conceptualization, data curation, writing original draft, review and editing, and project administration; Jahagirdar V contributed to writing original draft, review, and editing; Muhanna A contributed to investigation and methodology; Kennedy KF contributed to formal analysis, data curation, validation, and visualization; Helzberg JH contributed to supervision, writing, editing, and project administration; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Saint Luke’s Health System Institutional Review Board (Approval No. SLHS-21-057).
Informed consent statement: Informed consent was not obtained from each patient evaluated since this project was completely retrospective and performed with an IRB exemption.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: John Patterson Campbell, MD, Doctor, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Saint Luke’s Health System of Kansas City and the University of Missouri-Kansas City, 4401 Wornall Road, Kansas City, MO 64111, United States. jpc6nf@umsystem.edu
Received: November 4, 2022
Peer-review started: November 4, 2022
First decision: January 3, 2023
Revised: January 15, 2023
Accepted: February 7, 2023
Article in press: February 7, 2023
Published online: February 27, 2023
Abstract
BACKGROUND

Alcoholic liver disease (ALD) remains one of the major indications for liver transplantation in the United States and continues to place a burden on the national healthcare system. There is evidence of increased alcohol consumption during the coronavirus disease 2019 (COVID-19) pandemic, and the effect of this on the already burdened health systems remains unknown.

AIM

To assess the trends for ALD admissions during the COVID-19 pandemic, and compare it to a similar pre-pandemic period.

METHODS

This retrospective study analyzed all admissions at a tertiary health care system, which includes four regional hospitals. ALD admissions were identified by querying a multi-hospital health system’s electronic database using ICD-10 codes. ALD admissions were compared for two one-year periods; pre-COVID-19 from April 2019 to March 2020, and during-COVID-19 from April 2020 to March 2021. Data were analyzed using a Poisson regression model and admission rates were compared using the annual quarterly average for the two time periods, with stratification by age and gender. Percent increase or decrease in admissions from the Poisson regression model were reported as incident rate ratios.

RESULTS

One thousand three hundred and seventy-eight admissions for ALD were included. 80.7% were Caucasian, and 34.3% were female. An increase in the number of admissions for ALD during the COVID-19 pandemic was detected. Among women, a sharp rise (33%) was noted in those below the age of 50 years, and an increase of 22% in those above 50 years. Among men, an increase of 24% was seen for those below 50 years, and a 24% decrease in those above 50 years.

CONCLUSION

The COVID-19 pandemic has had widespread implications, and an increase in ALD admissions is just one of them. However, given that women are often prone to rapid progression of ALD, this finding has important preventive health implications.

Keywords: Alcoholic liver disease, COVID-19, Alcoholic hepatitis, Alcoholic liver cirrhosis, Alcoholism, Pandemic, Young women, Alcohol-related disorders

Core Tip: An increase in alcoholic liver disease admissions was observed in the first year of the pandemic compared to the year prior to the pandemic with various “lock-downs” in place. This trend was most pronounced in the cohort of women below the age of 50.