Women and Black patients have had an increase in alcohol-related gastrointestinal (GI) and liver disorders during the COVID-19 pandemic, according to a study in the Journal of Clinical Gastroenterology.
Researchers conducted a retrospective analysis of the Explorys Inc database, which includes an aggregate of electronic health record data from more than 40 major integrated United States health care systems from 1999 to 2021.
The study authors identified patients with alcoholic hepatitis, inflammation of the pancreas caused by alcohol, and alcoholic gastritis. They then compared patient data for 1 year during the COVID-19 pandemic (June 21, 2020, to June 20, 2021) with data from patients mostly unaffected by COVID-19 (before June 21, 2020).
A total of 8,445,720 patients who used health care services during the COVID-19 pandemic were identified, of whom 43.2% were men, 56.0% were adults aged 18 to 65 years, 23.4% were seniors aged >65 years, 54.7% were White, and 15.2% were Black. In addition, 65,587,860 patients who used health care resources before the COVID-19 pandemic were identified, of whom 45.9% were men, 60.6% were adults aged 18 to 65 years, 25.0% were seniors aged >65 years, 54.4% were White, and 9.8% were Black.
Patients aged >65 years in the pre-COVID-19 and COVID-19 cohorts utilized health care at about the same rate, and adults aged 18 to 65 years were less likely to use health care resources during COVID-19 (odds ratio [OR], 0.83; 95% CI, 0.827-0.829; P <.0001). Black patients in the COVID-19 cohort were more likely to use health care than Black patients in the pre-COVID-19 cohort (OR, 1.65; 95% CI, 1.644-1.650; P <.0001).
Overall, each alcohol-related disorder increased in prevalence during COVID-19 — alcoholic hepatitis: OR, 2.77 (95% CI, 2.70-2.84; P <.0001); alcoholic pancreatitis: OR, 3.67 (95% CI, 3.57-3.77; P <.0001); and alcoholic gastritis: OR, 1.70 (95% CI, 2.90-3.28; P <.0001).
Women were more likely to be affected by alcohol-related GI and liver disorders during the pandemic vs before the pandemic — alcoholic hepatitis: OR, 1.14 (95% CI, 1.08-1.20; P <.0001); alcoholic pancreatitis: OR, 1.13 (95% CI, 1.07-1.19; P <.00001); and alcoholic gastritis: OR, 1.21 (95% CI, 1.15-1.29; P <.0001).
Black patients in the COVID-19 cohort were much more likely to be diagnosed with each alcohol-related disorders — alcoholic hepatitis: OR, 2.63 (95% CI, 2.46-2.81; P <.0001); alcoholic pancreatitis: OR, 2.17 (95% CI, 2.05-2.30; P <.0001); and alcoholic gastritis: OR, 3.09 (95% CI, 2.90-3.28; P <.0001).
The researchers noted that they may have underestimated or overestimated the prevalence of disease, as it is impossible to validate diagnostic codes. Additionally, the Explorys data do not include information about socioeconomic status, geographic data, specific indications for medications prescribed, and other variables.
“The most striking demographic shift observed in these data is the relative increased burden of alcohol-related GI and liver disease on African Americans,” the investigators commented. “For each of the three disorders studied, African Americans suffered higher rates of disease during the pandemic than before, with OR >2 in alcoholic hepatitis, alcoholic pancreatitis, and alcoholic gastritis. This is in comparison to Caucasians, who saw a decline in the rate of all diseases.”
Damjanovska S, Karb DB, Cohen SM. Increasing prevalence and racial disparity of alcohol-related gastrointestinal and liver disease during the COVID-19 pandemic: a population-based national study. J Clin Gastroenterol. Published online January 10, 2022. doi: 10.1097/MCG.0000000000001665