Pandemic-fueled alcohol abuse creates a wave of hospitalization for liver disease

Liver disease associated with alcoholism has been a serious problem even before the pandemic, with 15 million people nationwide diagnosed with this condition and hospitalizations doubling in the last decade.

This article was published on Wednesday, February 10, 2021 Kaiser Health News.

Along Ali Kahan

As the pandemic recurs thousands of recovering alcoholics, hospitals across the country report a dramatic increase in alcohol-related hospitalizations for serious illnesses such as alcoholic hepatitis and liver failure.

Liver disease associated with alcoholism was an ever-increasing problem, even before the pandemic. 15 million people have been diagnosed Nationwide and in hospital Doubled in the last 10 years..

However, the pandemic has dramatically increased casualties. National figures are not available, but hospitalizations for alcoholic liver disease at the University of Southern California’s Keck Hospital increased by 30% in 2020 compared to 2019, with transplant livers treating alcoholic conditions. Specialist Dr. Brian Lee said. Hospital experts at the University of Michigan, Northwestern University, Harvard University, and Mount Sinai Health System in New York City said hospitalization rates for alcoholic liver disease have risen by up to 50% since March.

High level of alcohol intake Leads to the constellation of liver disease Due to toxic by-products associated with ethanol metabolism.In the short term, these by-products can be triggered Extensive inflammation It leads to hepatitis. In the long run They can guide Characteristics of adipose tissue accumulation and scarring of cirrhosis-this can then cause liver cancer.

Alcohol metabolism varies from person to person, so these diseases Can appear After just a few months of heavy drinking. Some people can take large doses without experiencing side effects for a long time. Others can suffer from a severe immune response that is rapidly sent to the hospital.

Major liver disease specialists and psychiatrists believe that the quarantine, unemployment, and despair associated with covid-19 are causing the incident to explode.

“There was a tremendous influx,” said Dr. Hariprya Maddur, a hepatologist at Northwestern Medicine. Many of her patients “did well” before the pandemic, avoiding recurrence for years. However, under the stress of a pandemic, “Suddenly [they] I was in the hospital again. “

Throughout these facilities, the age of patients hospitalized for alcoholic liver disease is declining. Dr. Raymond Chung, a hepatologist at Harvard University and chairman of the American Association for the Study of Hepatology, said the increasing illness of people under the age of 40 was “worrisome for years.” .. “But what we are seeing right now is really dramatic.”

Maddur has also treated many young adults hospitalized for jaundice and bloating. This is a pattern resulting from the intensifying economic struggle of the pandemic era facing vital statistics. At the same time, these young adults can enter the housing market or start a family, making entry-level employment increasingly difficult, especially in the vast and crippled hospitality industry. “They have a mouth to feed and an invoice to pay, but they have no job, so they turn into liquor as the last coping mechanism left,” she said.

Women may suffer disproportionately to alcoholic liver disease during a pandemic. Metabolize alcohol at a slower rate Than men.Low level Enzymes involved in the decomposition of ethanol High levels of toxins in the blood cause more organ damage in women than in men who drink the same amount. (((CDC is recommended For men it is less than 2 cups, while for women it is less than 1 cup per day. )

Dr. Jessica Melinger, a hepatologist at the University of Michigan, said socially that “pandemic stress is, in a sense, specifically targeted at women.” She said that lower wages, less stable work and the burden of childcare are more likely to rest on women’s shoulders.

“If you have all these additional stressors, all the forms of support are gone, and all you have is a bottle, that’s what you can count on,” Melinger said. “But women who drink like men get sick sooner.”

Nationwide, more adults are looking at bottles during a pandemic: One study found alcohol consumption in the spring of 2020 14% increase Drinkers consumed compared to the same period in 2019 Almost 30% more Than the month before the pandemic.Unemployment, isolation, lack of everyday structure, boredom are all Increased risk With enhanced alcohol use.

“The pandemic has created an uneasy relationship with our alcohol,” said Dr. Timothy Fon, a UCLA addiction psychiatrist. “We welcomed it to our home as crutches and our best friend.”

These recurrences, and the hospitalizations they cause, can be life-threatening.At least 1 in 20 patients with alcohol-related liver failure Die before leaving Hospitals and alcohol-related liver disease The main causes of transplantation..

The disease also makes people more susceptible to covid: patients with liver disease die from covid At three times the rate Without it, alcohol-related liver disease has been shown to increase the risk of death from additional covids. 79% To 142%..

Some doctors, such as Maddur, are concerned that stressors and liver disease, which lead to increased alcohol consumption, may continue to grow even after the blockade is lifted. “I think we’re just at the tip of this,” she said. “Quarantine is one thing, but the recession doesn’t go away anytime soon.”

Others like Lee are cautious but more optimistic. “The vaccine is coming to a pharmacy near you, covid-19 is over, and things start to return to normal,” he said. “But the real question is whether public health authorities decide to act in a fighting way. [alcoholic liver disease]..

“People are just fighting to deal with it every day.”

This story was created by KHN, Issue California Healthline, Editorial independent service California Healthcare Foundation..

Eli Kahan: [email protected], @emcahan