B0511 - Increased Hospital Admission Rates From Alcohol-Related Liver Disease Did Not Impact Mortality During the COVID Pandemic

Mattie K. White, MD, Priya Sasankan, MD, MBA, Ruishen Lyu, MS, John McMichael, PhD, Jamak Modaresi Esfeh, MD
Cleveland Clinic Foundation, Cleveland, OH

Introduction: Alcohol related liver disease (ALD) is associated with high mortality, accounting for 48% of cirrhosis-related deaths in the US. Studies show excessive alcohol intake has increased by 21% in the US since the COVID pandemic. Our study aims to compare pre-COVID to pandemic hospitalization and mortality rates to assess the burden of COVID on ALD.

Methods: This was a retrospective, IRB approved, study of patients admitted for ALD from January 2019-December 2021. ALD included diagnosis of alcohol cirrhosis, alcohol hepatitis, alcohol fatty liver disease, and acute on chronic liver failure due to alcohol. Pre-COVID admissions ranged January 2019-February 2020 and pandemic ranged March 2020-December 2021. The 30-day mortality was defined as patient death date 30 days or less from admission. The change in ALD admissions through time was analyzed with a local polynomial regression smoothing function plot comparing the average number of monthly pre-COVID ALD admissions to each monthly number of pandemic ALD admissions, and the differences were compared using t-test. Univariate and multivariate analysis with Cox proportional hazards regression model was performed. Pre-COVID and pandemic 30-day mortality rates were compared with Kaplan-Meier survival curve, using a 95% confidence interval. R (version 3.6.2; Vienna, Austria) was used for analyses and p-value< 0.05 was considered statistically significant.

Results: Among 688 ALD admissions, 249 were pre-COVID and 439 were pandemic. Pre-COVID and pandemic patients were similar with males (62% vs 61%), average age (56 vs 55), prior diagnosis of cirrhosis (37% vs 33%, p=0.41) and/or alcohol hepatitis (70% vs 65%, p=0.29), respectively. The average number of monthly ALD admissions pre-COVID was 18. During the pandemic, the number of monthly ALD admissions increased to 23 (range 20-26) after restrictions were first enforced, from May-September 2020, then again increased to 26 (range 20-35) after Omicron restrictions were re-enforced, from December 2020-August 2021 (Table 1). The 30-day mortality rate between pre-COVID and the pandemic was not significantly different by univariate (HR 1.21, CI 0.67-1.88, p=0.67) or multivariate analysis (HR 1.54, CI 0.90-2.64, p=0.11) (Figure 1).

Discussion: This study demonstrates a significant increase in the number of ALD admissions during the pandemic, particularly following enforcement of public health restrictions. Despite this increase, the 30-day mortality rate has not been impacted.




Disclosures:


Mattie K. White, MD, Priya Sasankan, MD, MBA, Ruishen Lyu, MS, John McMichael, PhD, Jamak Modaresi Esfeh, MD. B0511 - Increased Hospital Admission Rates From Alcohol-Related Liver Disease Did Not Impact Mortality During the COVID Pandemic, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.