Heringer Daniel L, Costa Gabriel P A, Weleff Jeremy, Rodrigues Victor, Sengupta Shreya, Anand Akhil
Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, SP, Brazil; Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, United States.
Faculdade de Medicina, Universidade de Ribeirão Preto, SP, Brazil.
Ann Hepatol. 2025 Jan-Jun;30(1):101742. doi: 10.1016/j.aohep.2024.101742. Epub 2024 Dec 7.
The COVID-19 pandemic has resulted in a greater incidence of alcohol-associated liver disease (ALD) and simultaneously magnified health-related inequalities. We evaluated the impact of race and ethnicity on ALD-related hospitalizations in Brazil.
An interrupted time series analysis was used to estimate ALD-related hospitalization in public hospitals in Brazil. Monthly hospitalization rates for 34 consecutive months before and after the point of interruption (March 2020) were calculated using the Sistema de Informações Hospitalares database across four ethnic groups: Black, Pardo, Black, and Pardo combined, and Others (White and Unknown Ethnicity).
A total of 84,787 ALD-related hospitalizations were recorded during the study period. The mean age of hospitalized patients was 53 years (SD=12.5); 83.6% were male. Immediately after the start of the pandemic, there was a statistically significant decrease in monthly ALD-related hospitalization rates for the whole population and for all ethnic groups. Subsequently, compared to pre-pandemic rates, there was a statistically significant trend increase in the referred hospitalization rates for the total population (0.065, 95% CI= 0.045 to 0.085, p<0.01), black population (0.0028, 95% CI= 0.006 to 0.050, p<0.05), pardo population (0.077, 95% CI= 0.063 to 0.090, p<0.01), and for black and pardo combined population (0.066, 95% CI= 0.053 to 0.079, p<0.01); however, the increase in hospitalization rates among the Others population (0.059, 95% CI= -0,014 to 0.133, p>0.1) was not statistically significant.
The pandemic impacted ALD-related monthly hospitalization rates and disproportionately impacted Black and Pardo populations in Brazil.
新冠疫情导致酒精性肝病（ALD）发病率上升，同时加剧了健康相关的不平等现象。我们评估了种族和民族对巴西ALD相关住院情况的影响。
采用中断时间序列分析来估计巴西公立医院中与ALD相关的住院情况。利用医院信息系统数据库计算中断点（2020年3月）前后连续34个月中四个种族群体的每月住院率：黑人、帕尔多混血人种、黑人和帕尔多混血人种合并群体以及其他群体（白人和种族不明者）。
研究期间共记录到84,787例与ALD相关的住院病例。住院患者的平均年龄为53岁（标准差=12.5）；83.6%为男性。疫情刚开始后，全体人群以及所有种族群体与ALD相关的每月住院率均出现了统计学上的显著下降。随后，与疫情前的比率相比，全体人群（0.065，95%置信区间=0.045至0.085，p<0.01）、黑人种族群体（0.0028，95%置信区间=0.006至0.050，p<0.05）、帕尔多混血人种群体（0.077，95%置信区间=0.063至0.090，p<0.01）以及黑人和帕尔多混血人种合并群体（0.066，95%置信区间=0.053至0.079，p<0.01）的转诊住院率出现了统计学上的显著上升趋势；然而，其他群体（0.059，95%置信区间=-0.014至0.133，p>0.1）住院率的上升在统计学上并不显著。
疫情影响了与ALD相关的每月住院率，且对巴西的黑人和帕尔多混血人种群体产生了不成比例的影响。
