During pandemic, hospitals see increase in alcohol-related liver disease

Just months after the start of the pandemic, Kelly White, a 52-year-old mother of three, found herself extremely nauseous and unable to handle alcohol.

White, from Chicago, had been fired when the country went on lockdown, and she found herself at home doing nothing. Having struggled with alcohol in the past, she found solace in drinking and began to triple her alcohol intake, often starting early in the morning and drinking throughout the day.

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She said, however, that everything seemed very normal to her.

“When I was drinking my vodka watching the news, they were drinking wine,” she said. “I had the impression that alcohol was very acceptable at all times of the day. It didn’t matter.

Kelly White, 52, of Chicago, was hospitalized with alcohol-related liver damage last July.Jack White

That changed one day last July when she felt so sick that she had to go to the hospital. There, doctors found that she was suffering from inflammation of the liver from drinking alcohol, called alcoholic hepatitis, as well as cirrhosis, which is a permanent scarring of her liver.

White is not an outlier. The number of Americans being treated for severe alcohol-related liver disease has increased during the pandemic, experts told NBC News.

“What we’ve seen during Covid-19 is really a dramatic increase in hospital admissions for alcohol-associated liver disease,” said Dr. Brian Lee, assistant professor of clinical medicine and transplant specialist hepatic at the Keck School of Medicine at the University of Southern California.

I had the impression that the alcohol was very acceptable at all times of the day. It didn’t matter.

“Because of things like blockages or stress at home, people started drinking more, didn’t realize they were drinking harmful amounts,” he said. And then they come “to the hospital with life-threatening liver disease.”

Lee said USC has seen a 30% increase in hospital admissions for alcohol-related liver disease since March 2020. This includes people who previously had a drinking problem under control as well. than those who had no history of alcohol problems, a trend Lee said that was worrying.

The typical patient, Lee said, is a young woman under the age of 35 with no history of alcohol problems. Women have been disproportionately affected by the pandemic, which may cause them to drink more, especially those with the added burden of childcare.

“They might have had a glass or two of wine a night before the pandemic,” he said. “Now they drink maybe half a bottle or a full bottle of wine and then come to the hospital with terminal liver disease and they didn’t even know it. “

Experts say it will take about two years to collect nationwide data on the increase in hospitalizations for alcohol-related liver disease, but emerging data corroborates Lee’s observations at USC.

A recent study published in the journal Alcohol and alcoholism found that hospital referrals to a liver care center at Johns Hopkins Hospital in Baltimore for alcohol-related liver damage increased by almost 50% in the last months of 2020 compared to the same period the previous year.

Researchers at Johns Hopkins University have reviewed the charts of nearly 500 patients who have been referred to a care center specializing in the treatment of liver problems. They found that in 2020, 46% of patients referred to their liver care center were due to alcohol-related liver disease, up from 31% the year before.

Alcohol-related liver disease “has such serious implications,” said study co-author Dr. Victor Chen, assistant professor of medicine at Johns Hopkins, including bleeding in the gut or liver cancer later in life.

Dr Raymond Chung, director of the Center for Hepatology and Liver at Massachusetts General Hospital, said he had seen an increase of about 40% in the number of patients admitted with alcoholic hepatitis during the pandemic compared to previous years.

Like Lee, Chung has also noticed a striking increase in hospital admissions among those under 40. The rate was twice as high as in previous years at his facility, and the youngest patient was in his twenties.

“This is the collateral damage from Covid-19,” Chung said. “It is the isolation, depression, loss of jobs, hopelessness and hopelessness that have been triggered by Covid-19.”

A “natural progression”

Chen, of Johns Hopkins, said he was not surprised by the rising rates of alcohol-related liver problems, calling them a “natural progression” based on previous surveys that have shown not only that Americans bought more alcohol, but they also consumed it in larger amounts.

A investigation from the American Psychological Association found that one in four Americans reported drinking more because of the stress caused by the pandemic. Another study, also conducted during the pandemic, found a 41% increase in the number of days women drank heavily, defined as four or more drinks in a few hours.

The death rate for severe alcoholic hepatitis can reach 40 percent, Chen said, because there are few treatment options available. For those who fail the initial treatment, the risk of death can be as high as 70%.

Liver damage from alcohol can appear relatively quickly in people who consume large amounts of it.

If alcohol intake is heavy enough, a few months of binge drinking can be enough to cause permanent liver damage, Chung said.

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While there are no hard limits on the number of drinks to avoid liver disease, the guidelines for what is considered heavy drinking are more than 14 drinks per week for men and more than seven drinks a week for women, he said.

Warning signs of liver damage may include abdominal pain, yellowing of the skin, and nausea or vomiting.

For many Americans, the pandemic is no longer a priority: the blockages have long been lifted and life is returning to a semblance of normalcy. But for Lee, the number of patients with alcohol-related liver disease continues to rise, a worrying new trend.

“We have seen a dramatic drop in Covid-19, but we are still seeing an increase in alcohol-related liver disease that persists,” he said. “What does this mean for the future? “

In White’s case, while she has permanent scars on her liver, she has not had a sip of alcohol since being hospitalized last summer and will celebrate a year of abstinence on July 20.

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