The Impact of COVID-19 on Alcohol-associated Hepatitis and Alcohol-associated Cirrhosis

Division

South Atlantic

Hospital

Trident Medical Center

Document Type

Manuscript

Publication Date

9-1-2026

Keywords

Humans, Male, COVID-19, Female, Middle Aged, Hepatitis, Alcoholic, Length of Stay, Liver Cirrhosis, Alcoholic, Aged, Adult, SARS-CoV-2

Disciplines

Digestive System Diseases | Gastroenterology | Internal Medicine | Medicine and Health Sciences

Abstract

BACKGROUND: During the COVID-19 pandemic, there was an increase in alcohol consumption. Here, we investigated COVID-19's impact on alcohol-associated hepatitis (AH) and alcohol-associated cirrhosis (AC) outcomes.

METHODS: Data from HCA's Enterprise Data Warehouse were examined (1/1/18 - 12/31/22). Patients aged > 18 years admitted for AH or AC were included. Pre- COVID-19 (2018-2019) and COVID-19 (2021-2022) time frames were evaluated. Statistical analyses were performed to evaluate LOS, discharge disposition, and mortality.

RESULTS: Of the 3177 patients with AH and AC, 1752 were admitted during COVID-19 (AH: 815, AC: 937). Patients in both groups were predominantly male (AH: 68%, AC: 72%) and White (AH: 73%, AC: 79%), with patients in the AH group being younger than those in the AC group (49 vs. 56 years). During COVID-19, 369/815 (45%) patients in the AH group and 447/937 (48%) patients in the AC group were diagnosed with COVID-19. In patients with AH, those diagnosed with COVID-19 had a 2.4-day longer LOS (OR: 2.36, p < 0.001), a 39% decreased likelihood of home discharge (OR: 0.61, p < 0.05), and a 223% increase in mortality (OR: 2.23, p < 0.05), compared to patients with AH, but without COVID-19. In patients with AC, those with COVID-19 had a 2.2-day longer LOS (OR: 2.19, p < 0.001), though discharge disposition and mortality were not significantly affected by a COVID-19 diagnosis.

CONCLUSIONS: Patients with COVID-19 and AH or AC had longer LOS. Mortality was increased in AH but not AC, perhaps reflecting greater acuity and severity of AH than AC.

Publisher or Conference

The American Journal of the Medical Sciences

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