IMPACT OF THE COVID-19 PANDEMIC ON RATES OF ALCOHOL-RELATED HEPATITIS ADMISSIONS IN A MULTI-HOSPITAL US HEALTH SYSTEM

Document Type

Conference Proceeding

Publication Date

10-1-2022

Publication Title

Hepatology

Abstract

Background: Alcohol consumption significantly increased during the Covid-19 pandemic. We previously reported a 50% increase in the proportion of alcoholic hepatitis (AH)-related hospital admissions during May-Sept 2020 compared to the same period in 2016-2019. We investigated admission patterns in 2021 to determine the impact of the ongoing pandemic on the rate of AH admissions in a large health system in metropolitan Detroit, Michigan, an area that experienced a severe early surge in Covid cases. Methods: We conducted a retrospective analysis using data from an integrated health system with four acute care hospitals. Patients were identified based on ICD-10 codes, supplemented with chart review, for the periods of May-Sept in the eras: 2016-2019 (pre-Covid); 2020 (early pandemic); and 2021 (late pandemic). Demographic data, MELD score, and liver-related outcomes were investigated. Chi-square tests were used to compare rates of AH admissions (as a proportion of total admissions). Characteristics of AH patients were compared across eras using ANOVA for numeric variables and Chi-square tests for categorical variables. Multivariate logistic regression was used to identify factors associated with liver-related outcomes. Results: A total of 402 patients were admitted for alcoholic hepatitis during the 3 eras. The rate of AHR admissions was significantly higher in 2020 (0.31%) compared to 2016-2019 (0.21%, p=.001) and 2021 (0.13%, p<.001). However, the rate of AH admissions in 2021 was significantly lower than in 2016-2019 (p=.001). Baseline characteristics of AH patients were similar across time, except for race; a larger proportion of Black patients were admitted in 2020 (p=.011) and 2021 (p=.036) compared with 2016-2019. Era was associated with initiation of liver transplant evaluation for AH (significantly higher in 2021 than other eras, p<.001 for both) but was not associated with ICU admission, initiation of dialysis, or death. Higher MELD score at admission was associated with higher risk of ICU admission (p<.001), dialysis (p<.001), and death (p=.004) in all eras. Black patients were less likely to initiate transplant evaluation compared to those of other races (p=.034). Conclusion: Hospital admissions for alcoholic hepatitis were higher during the height of 2020 Covid-era restrictions compared with similar pre-pandemic and later pandemic periods. (Figure Presented).

Volume

76

First Page

S975

Last Page

S976

Find It @ Sladen

Share

COinS