Alcohol-Related Liver Admissions Surge During the Pandemic

A study analyzing national hospitalization data has revealed a concerning increase in hospital admissions for alcohol-related hepatitis, a potentially life-threatening liver inflammation, coinciding with a boom in alcohol sales during the pandemic.

The research shows a rise in cases of alcohol-related liver disease from 2016 to 2020, with a particularly significant increase in 2020, the year COVID-19 arrived in the U.S. Compared to 2019 levels, there was a 12.4% overall rise in hospital admissions, with younger patients aged 18 to 44 experiencing a staggering 20% increase. The severity of the consequences was also evident as in-hospital deaths rose by 24.6% in 2020 compared to the previous year.

While previous observations of this issue were largely anecdotal or based on regional studies, this study sheds light on the growing problem on a national scale, according to Dr. Kris Kowdley, professor at Washington State University’s Elson S. Floyd College of Medicine and senior author of the study published in the American Journal of the Medical Sciences.

“Severe liver disease seems to be rising over time, but it appears to have increased even more dramatically during the pandemic,” stated Kowdley, who is also the director of the Liver Institute Northwest. “We confirmed that alcohol-related hepatitis hospital admissions increased continually from 2016 to 2020. We also found that younger patients and women had a higher increase in in-hospital mortality compared to their counterparts.”

Alcohol-related hepatitis primarily affects heavy and regular drinkers, typically those who consume more than four alcoholic drinks daily. Symptoms can include abdominal pain, loss of appetite, vomiting, and jaundice. If left untreated, the illness can lead to permanent liver damage known as cirrhosis and may even be fatal.

Drawing on data from the National Inpatient Sample, which tracks hospitalizations in 37 states, the study examined approximately 823,000 patients hospitalized with alcohol-related hepatitis from 2016 to 2020. While this group represents a relatively small proportion of the U.S. population, researchers are alarmed by the rapid increase in cases and severity of outcomes.

In 2016, approximately 146,000 patients were admitted to the hospital with alcohol-related hepatitis. By 2019, this number had risen to nearly 169,000, indicating a 5.1% annual increase from 2016 levels. The surge became more pronounced in 2020, with admissions surpassing 190,000—a 12.4% increase compared to 2019.

Although alcohol-related hepatitis is generally more prevalent in men, the study found that women experienced a greater increase in cases, rising by 14.6% between 2019 and 2020, compared to a 12.2% increase among men. Geographically, the highest number of cases were observed in the U.S. South, but the West saw the most significant surge.

The study also identified a shift in the socioeconomic distribution of cases. Between 2016 and 2019, the two highest income groups exhibited the largest increase in alcohol-related hepatitis. However, in 2020, the lowest income group demonstrated the highest rise in cases.

“It’s likely that a variety of factors contributed to a much higher rate of alcohol consumption during the pandemic, such as social isolation and fewer barriers to excessive drinking,” explained Kowdley. “The association between lower income and increased cases may also be linked to the stress, anxiety, and financial concerns associated with the pandemic.”

The findings emphasize the need for a multidisciplinary approach to treating individuals suffering from alcohol use disorders. This approach should encompass mental health and behavioral therapy, nutritional counseling, and increased utilization of medications that aid in reducing alcohol cravings. It is equally crucial to combat the stigma associated with alcohol-related liver disease.

“We need to recognize and treat alcohol-related hepatitis as a disease like any other, without stigmatizing those who suffer from this illness,” Kowdley stressed. “As healthcare providers and patients, we must be aware that alcohol-related hepatitis can be a life-threatening disorder.”

The study’s 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 from the University of California, San Francisco.