S1085 Effect of the COVID-19 Pandemic on Hospitalization for Alcohol-Associated Hepatitis

Abstract

Introduction: The COVID-19 Pandemic had huge implications related to loss of people, jobs, money and social interactions. Its impact has varied across geographical, socioeconomic and policy factors. These stressors are known to increase alcohol use along with other high risk health behaviors. In this study we aimed to evaluate effects of the COVID-19 pandemic on alcohol associated hepatitis (AAH) incidence in the Midwestern population. Methods: Consecutive adult admissions for symptomatic AAH (defined by alcohol use, evidence of liver injury and total bilirubin ≥dL) to our one academic and two community hospitals located in a Midwestern USA metro area with a population of about 1 million people were included. We included the years 2016 to 2019 as controls and 2020 as the pandemic year. The years were further divided by quarter as pandemic related changes started in the second quarter of 2020. Patients were identified using ICD-10 code k70.10 and k70.11. Severe AAH is based on admission Maddrey's Discriminant Function ≥r MELD-a ≥ Results: A total of 282 hospitalizations for symptomatic AAH occurred between 2016 to 2020. As shown in Table 1, hospitalizations for AAH over 5 years were similar in gender and race, but patients in 2016 were older compared to other years. Compared to the same quarters in the previous 4 years, the number of hospitalizations for symptomatic AAH during the pandemic year more than doubled, with the sharpest rise in the 3rd and 4th quarters (Figure 1). The proportion of severe AAH and inpatient mortality was similar to previous years. Conclusion: Our results show significant rise in hospitalization for AAH in the Midwestern USA population during the COVID-19 pandemic. This rise was particularly sharp in the 3rd and 4th quarter of 2020. This is likely an effect of prolonged pandemic related stressors. The rise in AAH might be higher in other states as our state did not have a stay home mandate at any point during the pandemic.