Departments of Internal Medicine.
Gastroenterology and Hepatology, UCSF Fresno, Fresno, CA.
J Clin Gastroenterol. 2022 Mar 1;56(3):e171-e175. doi: 10.1097/MCG.0000000000001627.
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.
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。
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