Epidemic within pandemic: Alcohol-associated hepatitis and COVID-19.

Abstract

An increase in alcoholic beverage sales was observed during the peak of the COVID pandemic in the US. Little is known about the impact of SARS-CoV-2 infection among hospitalized alcohol-associated hepatitis (AH) patients. In this study we 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. We observed an ~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 was the fastest growing AH group, representing a 23% increase in 2020. Approximately 1.8% of hospitalized AH patients had a SARS-CoV-2 infection. An infection with SARS-CoV-2 significantly worsened the mortality among patients with AH (11.4% vs. 4.1%, p<0.0001), especially among older AH patients with concomitant comorbidities 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). Our study highlighted the rise in AH cases during the COVID-19 pandemic. Screening and appropriate management of excessive alcohol use and the preventive measure such as the recommendation of COVID-19 vaccination should be considered to prevent the morbidity and mortality among patients with ALD.