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Is Rise in Liver Damage Tied to More Drinking During Lockdowns?

FRIDAY, May 14, 2021 -- Many people drank more to cope with the stress of the coronavirus pandemic and the restrictions it placed on daily life, and now a new study suggests that all of this drinking is causing a serious spike in alcohol-related diseases.

"Incidence of hospitalizations for alcohol-related gastrointestinal (GI) and liver disease increased quite dramatically since the beginning of the COVID-19 lockdowns and has continued during the re-opening stage," said study author Dr. Waihong Chung. He is a research fellow in the division of gastroenterology at the Warren Alpert Medical School of Brown University, in Providence, R.I.

"Our study only looked at patients who are sick enough to come to the hospital, but we expect that the problem is way worse in outpatient settings where patients are not sick enough to seek care…yet," Chung added.

The study is scheduled to be presented May 21 at the virtual Digestive Disease Week meeting. Findings presented at meetings should be considered preliminary until published in a peer-reviewed journal.

For the study, the researchers looked at people who saw a specialist for alcohol-related GI and liver conditions while hospitalized during the COVID-19 lockdown and re-opening phases in Rhode Island from March 23 to May 10, 2020, and June 1 to July 19, 2020, respectively. The investigators compared these to consults that took place during the same periods in 2019.

The total number of all GI consults fell by 27% during lockdown because of widespread shelter-in-place orders, but the proportion of those due to alcohol-related GI and liver diseases jumped by close to 60%, including consultations for alcohol-related hepatitis or inflammation of the liver and cirrhosis (scarring of the liver), the study found.

While the number of GI visits for all conditions returned to pre-pandemic levels as Rhode Island began to reopen, the proportion of those for alcohol-related issues increased by 80%, the study found.

What's more, the number of people coming to the hospital with alcoholic hepatitis more than doubled during re-opening compared to 2019, and more people needed endoscopic procedures during their stay, which suggests that they were experiencing GI bleeds, a sign of more serious disease.

Other symptoms of severe alcoholic hepatitis may include jaundice (or yellowing of the skin and eyes), abdominal pain in the right quadrant where your liver sits, nausea, vomiting, confusion, leg swelling and/or black stools.

Dr. Steven Flamm, a liver specialist at Northwestern Memorial Hospital, in Chicago, explained that "these people drink a lot but have never been sick, and then they become deathly ill and are hospitalized."

It's a very dramatic turn of events, said Flamm, who was not part of the new study. "They get so sick that even if they are scared to leave the house due to COVID-19, they end up coming in to the hospital," he added.

There are no great treatments for acute alcohol-related hepatitis, Chung added, and the only way to prevent it from progressing to cirrhosis is to stop drinking.

"Let it be a wake-up call and seek help to stop drinking," Chung urged.

Although the study only looked at hospital admissions across Rhode Island, "the findings are likely an accurate reflection in many other urban and suburban cities across the U.S.," he said.

They certainly mirror what Dr. David Bernstein, chief of hepatology and director of the Sandra Atlas Bass Center for Liver Diseases at Northwell Health in Manhasset, N.Y., sees at his hospital.

"The number of people being admitted to the hospital related to alcohol use since the COVID-19 epidemic is up — especially in young people," said Bernstein, who was not involved in the new study.

It was the perfect storm in many ways. "Many people lost their jobs or felt isolated and became depressed," Bernstein said. "Liquor stores were deemed an essential business and people went from going out once or twice a week and having a glass or two of wine to drinking every night."

Sources

  • Waihong Chung, MD, PhD, research fellow, division, gastroenterology, Warren Alpert Medical School of Brown University, Providence, R.I.
  • Steven Flamm, MD, liver specialist, Northwestern Memorial Hospital, Chicago
  • David Bernstein, MD, chief, hepatology, director, Sandra Atlas Bass Center for Liver Diseases, Northwell Health, Manhasset, N.Y.
  • Digestive Disease Week, presentation, May 14, 2021

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