Chung W. et al. Abstract 436. Presented at: Digestive Disease Week (virtual); May 13, 2020.
Volume on consults for alcohol-related GI, liver diseases remain elevated throughout COVID-19
Despite ongoing COVID-19 infection control restrictions, volumes of inpatient consults for alcohol-related gastrointestinal and liver diseases had significantly decreased at the onset of the COVID-19 pandemic, but quickly returned to normal levels, according to an expert presentation during a press conference in advance of Digestive Diseases Week.
“We do believe that the locked down of the pandemic has a direct effect on patients’ alcoholic consumption,” Waihong Chung, MD, PhD, research fellow for the division of gastroenterology at the Warren Alpert Medical School of Brown University, said during his presentation. “I want to stress that many patients with alcoholic related disorders aren’t admitted to hospital right away or at all so we believe that health problems related to increased alcohol use may be even higher in a community. So, we urge primary care physicians or GI doctors and hepatologists to double down on questioning patients about their alcohol use and to identify people who might need help sooner or later.”
Chung — lead researcher of the study — and colleagues performed a hospital system-wide audit of inpatient gastrointestinal consulting performed during the lockdown phase (March 23, 2020 – May 10, 2020; n = 558) and reopening phase of the pandemic (June 1, 2020 – July 19, 2020; n = 713). Then, compared the data with data from 2019 to determine changes in disease burden.
The patients’ discharge summaries were used to derive GI diagnoses.
“We found the total of all GI consults declined by about 27% in the locke down phase due to limitations in the hospital capacity but the proportion of consults for alcohol-related liver disease increased sharply by about 60%. In particular we saw about 53% increase in acute alcoholic hepatitis, which is a very serious condition with high short-term mortality,” Chung said. “In the reopening phase the total volume of GI consults returned to pre-pandemic levels.”
According to researchers, the proportions of consults for non-alcohol–related liver diseases, biliary obstruction/injury, inflammatory bowel diseases, or gastrointestinal bleeding did not significantly change. During the reopening phase, the volume of consults was restored to 101% of that of the same period in 2019.
Results showed the proportion of consults for alcohol-related GI and liver diseases remained elevated by 78.7% (P = .01); however, the proportion of consults for alcoholic hepatitis increased by 127.2% (P < .01). In addition, the proportion of patients with alcohol-related GI and liver diseases who required inpatient endoscopic interventions was significantly higher (34.6% vs. 13.8%; P = .04). However, there was no statistical difference in the average age, Maddrey’s discriminant function, or model for end-stage liver disease score, among patients with alcoholic hepatitis or alcoholic cirrhosis in 2020 vs. those in 2019.