More Alcohol-Related Hepatitis Following COVID-19
Rates of hospital admissions for alcohol-related hepatitis have increased since 2019, and certain groups are more at risk.
By Sneha Bhadti
In the time following the start of the COVID-19 pandemic, it has become clear that the pandemic has impacted all areas of life. During the COVID-19 lockdowns, the already booming alcohol industry drastically increased sales, according to Nielsen reports, as people flocked to their computers to order drinks online. More people turned to alcohol, likely to quell their stress and loneliness brought about by repeated lockdowns and gigantic shifts from their everyday freedoms to more restricted access to the outdoors. Post-pandemic, the health system is seeing the impact of this.
Alcohol-related hepatitis (ARH) is a non-infectious disease that occurs when the liver becomes damaged due to excessive alcohol intake. When someone drinks alcohol, the liver breaks down the alcohol and filters it out of their blood and eventually out of the body. Liver cells die during this process. The liver is able to grow new cells in order to replace any lost cells. However, excessive and prolonged drinking of alcohol will hinder new cell growth, leading to liver damage. If severe, ARH can be deadly.
In a study out of UCSF Fresno published in 2022, Dr. Aalam Sohal and fellow researchers identified that there was a sharp uptick in the number of hospital admissions for ARH in California between 2019 and 2020. Dr. Sohal collaborated with additional researchers to extend this research in a 2023 study, highlighting the effects of alcohol dependency during the pandemic on ARH hospitalizations on a national scale.
Alcohol-related hepatitis trends in the population
The researchers searched a database that provides records of hospitalizations for 37 states in the US. In total, 823,145 patients were identified to have hospital admissions due to alcohol-related hepatitis between 2016 and 2020, during which time there was also an increase of 12.9 percent in admissions.
The trend was not the same for all groups. A 19.8 percent increase in ARH hospital admissions was noted in people aged 18–44. This is in contrast to a 9 percent and 5 percent increase for people aged 45–64, and more than 65, respectively. While all ethnic groups were found to have higher rates of admissions due to ARH, the top three were Native Americans, African Americans, and Hispanic Americans. The researchers also highlighted the concerning trend that women’s admissions had heightened by 14.2 percent—higher than the increase of 12 percent for men.
COVID-19 lockdowns: were they a double-edged sword?
While the main reason for the COVID-19 lockdowns was positive—to limit the spread of the virus and ultimately save lives—lockdowns may have come with negative effects.
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Sohal and colleagues hypothesized that the groups most affected may have faced additional pressures that increased their drinking behaviors during lockdowns. For example, young people may have had to confront major challenges such as the transition of education from in person to virtual, job and income losses, and social isolation. Minorities may also have disproportionately faced financial strains. For example, Pew Research Center reported in May 2020 that 44 percent of African Americans and 61 percent of Hispanic Americans experienced a job loss or wage loss in their household due to the pandemic, compared to 38 percent of white Americans.
Differences in the ways in which women handle stressful situations were thought to be a driver in the increase in alcohol-related hepatitis cases in women. These differences are highlighted in research by Dr. Michael Pollard and associates, who surveyed 6,000 US adults in 2020 and found that women were heavier drinkers during the pandemic compared with before the pandemic. The rise in women drinking heavily is concerning due to biological differences between men and women that put women at a higher risk of developing ARH and having higher severities of the disease.
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Implications for the future
In an increasingly interconnected world, it is necessary to be prepared for the next pandemic. There are lessons to be learned from the COVID-19 pandemic in all realms, especially in healthcare. The results of this study shine a spotlight on the escalating number of post-pandemic alcohol-related hepatitis hospital admissions. The researchers concluded that healthcare decision-makers should identify strategies for the prevention, early diagnosis, and treatment of future ARH cases. On an individual level, we could all be aware of our own drinking habits and how they may affect our health.
This study was published in the peer-reviewed journal The American Journal of the Medical Sciences.
The information contained in this article is for informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
References
Lopez, M. H., Rainie, L., & Budiman, A. (2020, May 5). Financial and health impacts of COVID-19 vary widely by race and ethnicity. Pew Research Center. https://www.pewresearch.org/fact-tank/2020/05/05/financial-and-health-impacts-of-covid-19-vary-widely-by-race-and-ethnicity/
Pollard, M. S., Tucker J. S., & Green, H. D. (2020). Changes in adult alcohol use and consequences during the COVID-19 pandemic in the US. JAMA Network Open, 3(9), e2022942. https://doi.org/10.1001/jamanetworkopen.2020.22942
Sohal, A., Khalid, S., Green, V., Gulati, A., & Roytman, M. (2022). The pandemic within the pandemic: Unprecedented rise in alcohol-related hepatitis during the COVID-19 pandemic. Journal of Clinical Gastroenterology, 56(3), e171–e175. https://doi.org/10.1097/MCG.0000000000001627
Sohal, A., Chaudhry, H., Patel, J., Dhillon, N., Kohli, I., Dukovic, D., Roytman, M., & Kowdley, K. V. (2023). Impact of COVID-19 pandemic on alcohol-related hepatitis admissions: Analysis of nationwide data 2016–2020. The American Journal of the Medical Sciences, 1–10. https://doi.org/10.1016/j.amjms.2023.06.002
About the Author
Sneha Bhadti has earned a bachelor’s degree in Biomedical Sciences and a master’s degree in Health Economics. She currently works as a systematic reviewer and loves reading about the latest medical research. Sneha enjoys communicating science, especially translating complex science for the general public and decision-makers.
