Epidemic within a pandemic: Alcohol‐associated hepatitis and COVID‐19

Abstract

AbstractBackgroundThere was an increase in alcoholic beverage sales during the peak of the COVID pandemic in the United States. However, little is known about the impact of SARS‐CoV‐2 infection among hospitalized alcohol‐associated hepatitis (AH) patients.MethodsWe analyzed the available National Inpatient Data (NIS) data from 2020 to determine mortality and healthcare utilization among hospitalized AH patients with and without COVID‐19 in the United States.ResultsWe observed a ~15.6% increase in cases of hospitalized AH patients from 136,620 in 2019 to 157,885 in 2020, a significant increase from an average of 5.5% per annum despite an 8.7% decline in US hospital admissions over the same time span. Men younger than 40 were the fastest growing AH group, with a 23% increase in 2020. Approximately 1.8% of hospitalized AH patients had a SARS‐CoV‐2 infection, which significantly worsened the mortality among patients with AH (11.4% vs. 4.1%, p < 0.0001). This was especially true among older AH patients with concomitant conditions such as clinically apparent cirrhosis, acute renal failure, upper gastrointestinal bleeding, and sepsis. AH patients with COVID‐19 also had a longer length of stay (8.6 vs. 6.1 days, p < 0.0001) and higher hospital charges during the stay ($93,670 vs. $66,283, p < 0.0001) than those without COVID‐19.ConclusionOur study highlights the rise in AH cases during the COVID‐19 pandemic. Screening and appropriate management of excessive alcohol use and preventive measures such as COVID‐19 vaccination should be considered to reduce morbidity and mortality among patients with AH.