Effect of Increased Alcohol Consumption During COVID‐19 Pandemic on Alcohol‐related Liver Disease: A Modeling Study

Introduction: Alcohol is a known cause of liver cirrhosis, with its incidence increasing in relation to the total amount and duration of intake. Excessive consumption of alcohol remains the main cause of alcohol-related liver disease and associated complications and deaths. Aims: To delineate the drinking patterns and severity of alcohol consumption in alcoholic liver disease patients. Methods: A descriptive cross sectional study was conducted among 95 patients of both sexes with the diagnosis of alcoholic liver disease (ALD), who were admitted in Medicine ward at Nepalgunj Medical College, Nepalgunj. The diagnosis of ALD was confirmed by the criteria of the ICD-10-CM. The severity of alcohol drinking screened and categorized as “low-risk drinkers,” “hazardous drinkers,” and “harmful drinkers” were based on the AUDIT score. Results: Among a total of 95 ALD patients, the mean age was 45.10 ±7.60 years, the mean duration of alcohol use was 22.6 ±7.65 years and the average amount of alcohol consumed in grams/day was 240 ± 35. Majority of the patients consumed locally brewed alcohol, Raksi 46.3% followed by Jaad 22.1% and Others 11.6%. Very few patients consumed commercially available Spirits 6.3% or Beer 13.7%. Majority of patients were found to be drinking regular with intermittent bingeing pattern 61%, outside meal times 69.5% and hazardous drinking 53.7%. Conclusion: Overall our analyses indicated a precise picture of drinking patterns in ALD patients that are profoundly influenced on several cofactors like alcohol type, duration of exposure, drinking patterns, cultural habits, availability of homemade beverages and individual susceptibility. We recommend screening for alcohol abuse in all adult patients presenting to the hospital as early detection of ALD can decrease its both morbidity and mortality.

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Effect of Increased Alcohol Consumption During COVID-19 Pandemic on Alcohol-related Liver Disease: A Modelling Study

10.1101/2021.03.18.21253887 ◽

2021 ◽

Author(s):

Jovan Julien ◽

Turgay Ayer ◽

Elliot Tapper ◽

Carolina Barbosa ◽

William Dowd ◽

...

Keyword(s):

Liver Disease ◽

Alcohol Consumption ◽

Decompensated Cirrhosis ◽

Drinking Patterns ◽

Microsimulation Model ◽

The Us ◽

Short And Long Term ◽

Related Liver Disease ◽

The Impact

Objectives: The burden of alcohol-related liver disease (ALD) is surging in the US. There is evidence that alcohol consumption increased during the early periods of the coronavirus disease-2019 (COVID19) pandemic. We describe the impact of increased alcohol consumption on alcohol-related liver disease. Design: Microsimulation model Setting: Model parameters estimated from publicly available data sources, including national surveys on drug and alcohol use and published studies informing the impact of alcohol consumption on ALD severity. Participants: US residents Methods: We extended a previously validated microsimulation model that estimated the short- and long-term effect of increased drinking during the COVID-19 pandemic in individuals in the US born between 1950-2012. We modeled short- and long-term outcomes of current drinking patterns during COVID-19 (status quo) using survey data of changes in alcohol consumption in a nationally representative sample between February and April 2020. We compared these outcomes with a counter-factual scenario wherein no COVID-19 occurs, and drinking patterns do not change. Reported outcomes are for individuals aged 18-65. Main outcome measures: ALD-related deaths inclusive of HCC mortality, the prevalence and incidence of decompensated cirrhosis and hepatocellular carcinoma, and disability-adjusted life-years (DALYs) Results: Increases in alcohol consumption during 2020 due to the COVID-19 pandemic are estimated to result in to 8,200 [95% UI 7,700 - 8,700] additional ALD-related deaths (1% increase compared with the counter-factual scenario), 17,100 [95% UI 16,100 - 18,200] cases of decompensated cirrhosis (2% increase) and 1,100 [95% UI 1,100 - 1,200] cases of HCC (1% increase) between 2020 and 2040. Between 2020 and 2023, alcohol consumption changes due to COVID-19 will lead to 100 [100-200] additional deaths and 2,200 [2,200-2,300] additional decompensations in patients suffering from alcohol-related liver disease. Conclusions: A short-term increase in alcohol consumption during the COVID-19 pandemic can substantially increase long-term ALD-related morbidity and mortality. Our findings highlight the need for individuals and policymakers to make informed decisions to mitigate the impact of high-risk alcohol drinking in the US.

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