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大流行中的小流行:COVID-19 大流行期间酒精性肝炎发病率空前上升。

The Pandemic Within the Pandemic: Unprecedented Rise in Alcohol-related Hepatitis During the COVID-19 Pandemic.

机构信息

Departments of Internal Medicine.

Gastroenterology and Hepatology, UCSF Fresno, Fresno, CA.

出版信息

J Clin Gastroenterol. 2022 Mar 1;56(3):e171-e175. doi: 10.1097/MCG.0000000000001627.


DOI:10.1097/MCG.0000000000001627
PMID:34653062
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8843054/
Abstract

BACKGROUND AND AIM: The third leading preventable cause of death in the United States is excessive alcohol consumption. Our study sought to assess the impact of the coronavirus disease 2019 (COVID-19) on hospitalizations for alcohol-related hepatitis at a community hospital system. We hypothesized an increase in cases of alcohol-related hepatitis requiring inpatient management, mirroring the strain on economic and societal norms imposed by the COVID-19 pandemic. APPROACH/RESULTS: We performed a retrospective chart review to study the incidence of alcohol-related hepatitis in patients presenting to 3 community hospitals in Fresno, California, before and during the COVID-19. Data including patient demographics, markers of disease severity, and clinical course were extracted from electronic medical records for 329 patients included in the study. There was a 51% increase in the overall incidence of alcohol-related hepatitis requiring hospitalization between 2019 and 2020 (P=0.003) and 69% increase (P<0.001) after implementation of the stay-at-home orders. In addition, 94% (P=0.028) increase in rehospitalizations was noted in 2020 (P=0.028), a 100% increase in patients under the age of 40 (P=0.0028), as well as a trend towards a 125% increase (P=0.06) of female patients admitted with this diagnosis during the COVID-19 pandemic. CONCLUSIONS: Our study revealed drastic increases in severe alcohol-related hepatitis requiring inpatient management, specifically in patients under the age of 40 and in women during the COVID-19 pandemic. Given the high morbidity and mortality associated with severe alcohol-related hepatitis, these findings have far-reaching and lasting implications for our already strained health care system extending beyond the COVID-19 pandemic timeframe. Urgent public health interventions are needed to combat the rising misuse of alcohol and its consequences.

摘要

背景和目的:在美国,过量饮酒是导致死亡的第三大可预防原因。本研究旨在评估 2019 年冠状病毒病(COVID-19)对社区医院系统中酒精性肝炎住院的影响。我们假设需要住院治疗的酒精性肝炎病例会增加,这反映了 COVID-19 大流行对经济和社会规范造成的压力。

方法/结果:我们对加利福尼亚州弗雷斯诺的 3 家社区医院进行了回顾性图表审查,以研究 COVID-19 之前和期间,因酒精性肝炎而住院的患者的发病率。从电子病历中提取了 329 名入组患者的患者人口统计学、疾病严重程度标志物和临床病程数据。与 2019 年相比,2020 年因酒精性肝炎需要住院的总体发病率增加了 51%(P=0.003),在实施居家令后增加了 69%(P<0.001)。此外,2020 年的再住院率增加了 94%(P=0.028),40 岁以下的患者增加了 100%(P=0.0028),以及因该诊断而入院的女性患者增加了 125%(P=0.06)。

结论:我们的研究表明,需要住院治疗的严重酒精性肝炎急剧增加,特别是在 COVID-19 大流行期间,40 岁以下的患者和女性患者。鉴于严重酒精性肝炎相关的高发病率和死亡率,这些发现对我们本已紧张的医疗体系产生了深远而持久的影响,超出了 COVID-19 大流行的时间范围。需要采取紧急的公共卫生干预措施来应对酒精滥用及其后果的上升。

相似文献

[1]
The Pandemic Within the Pandemic: Unprecedented Rise in Alcohol-related Hepatitis During the COVID-19 Pandemic.

J Clin Gastroenterol. 2022-3-1

[2]
Soaring rates of alcohol-related hepatitis in the latter phase of the COVID-19 pandemic: A new normal?

JGH Open. 2023-1-13

[3]
Impact of COVID-19 pandemic on alcohol-related hepatitis admissions: Analysis of nationwide data 2016-2020.

Am J Med Sci. 2023-9

[4]
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J Gen Intern Med. 2024-9

[5]
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Hepatology. 2021-12

[6]
Alcohol-related hepatitis admissions increased 50% in the first months of the COVID-19 pandemic in the USA.

Liver Int. 2022-4

[7]
Impact of the COVID-19 pandemic on liver disease-related mortality rates in the United States.

J Hepatol. 2023-1

[8]
Intersection of Coronavirus Disease 2019 and Alcohol-associated Liver Disease: A Review of Emerging Trends and Implications.

Clin Ther. 2023-12

[9]
Patients with alcohol-related liver disease hospitalized during the COVID-19 pandemic experienced worse outcomes.

Ann Hepatol. 2023

[10]
Impact of the COVID-19 Pandemic on Hospitalizations for Alcoholic Hepatitis or Cirrhosis in Alberta, Canada.

Clin Gastroenterol Hepatol. 2022-5

引用本文的文献

[1]
Sex differences in severity, outcomes, and healthcare utilization in alcohol-associated hepatitis.

World J Hepatol. 2025-8-27

[2]
Assessing Efficacy of Interleukin-1 Blockade in Patients with Alcoholic Hepatitis: A Comprehensive Systematic Review of Emerging Evidence.

Life (Basel). 2025-7-15

[3]
Public health policies to prevent alcohol-related liver disease.

Nat Rev Gastroenterol Hepatol. 2025-6-4

[4]
Liver transplantation for alcohol-associated liver disease: The changing landscape.

Hepatol Forum. 2025-3-1

[5]
PRDM16 in thermogenic adipocytes mediates an inter-organ protective signaling against alcohol-associated liver disease.

Mol Cell Endocrinol. 2025-1-1

[6]
Developing a generic business case for an advanced chronic liver disease support service.

Frontline Gastroenterol. 2023-10-24

[7]
Changes in emergency department visits and mortality during the COVID-19 pandemic: a retrospective analysis of 956 hospitals.

Arch Public Health. 2024-1-12

[8]
Are Cisgender Women and Transgender and Nonbinary People Drinking More During the COVID-19 Pandemic? It Depends.

Alcohol Res. 2023

[9]
Fuel to the fire: The impact of COVID-19 on alcohol-associated hepatitis.

Alcohol Clin Exp Res (Hoboken). 2023-12

[10]
The changing epidemiology of adult liver transplantation in the United States in 2013-2022: The dominance of metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease.

Hepatol Commun. 2024-1-1

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