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1.
Gastroenterology ; 162(7):S-1223, 2022.
Article in English | EMBASE | ID: covidwho-1967425

ABSTRACT

Background COVID-19 pandemic and its resulting life stress could affect lifestyle including increased alcohol use. Mounting evidence has indicated rising prevalence in alcohol related liver disease (ALD) during pandemic. However, the studies were limited by single center data with cross-sectional design. We aimed to determine the nationwide effect of COVID- 19 pandemic on the prevalence as well as mortality of ALD among patients with alcohol use disorder (AUD). Methods Patient data were obtained from the Optum de-identified Clinformatics® database. Enrollees with a diagnosis of AUD who received care in hospital emergency department and/or inpatient service from January 2019 to December 2020 were included and followed up until March 2021. AUD were defined as having alcohol intoxication, withdrawal, and alcohol-related mental health disorders. We estimated the quarterly prevalence and 30-, 60-, 90-, and 180-day mortality during study period. Results There were no significant trends in mortality before the pandemic. The 30-day mortality decreased from 11.96% to 10.34% from Q1 to Q3 in 2019, then increased to 12.10% in Q1 2020. The increase between 2019 Q1 and 2020 Q1 was not significant. In contrast, the mortality rates increased from 2020 Q1 to 2020 Q2 and continued to increase during pandemic. Mortality rate elevated from 12.10% to 13.44% from 2020 Q1 to 2020 Q2, followed by 13.50% in Q3 and 14.94% in Q4. Similar pattern was seen in 60-day and 90-day mortalities. About a quarter of patient died at 90 days after diagnosis of ALD. The prevalence of ALD among patients with AUD fluctuated throughout 2019, with 53.77% in 2019 Q1 decreasing to 51.29% in 2019 Q3. It increased to 53.15% in 2019 Q4. The prevalence was higher in 2020 Q1 compare to 2019 Q1. However, during pandemic, the prevalence decreased to 53.98% in 2020 Q2 then bounced to 55.40% and 56.57% in 2020 Q3 and Q4. While the prevalence of ALD in AUD patients who visited ED increased from 2020 Q2 to 2020 Q4, the prevalence of ALD in hospitalized patient surged in 2020 Q2, followed by decreasing trend in latter half of 2020. The increasing trend was more prominent in patients aged <65 years than those $65 years. Males had a steeper increasing trend than females. While there was no significant change in prevalence of ALD among non-Hispanic Asians, the upward trend among non-Hispanic Whites and Blacks was significant. ConclusionsWedemonstrated an alarming rise in ALD mortality and increased prevalence among patients with AUD. The data were derived from patients with private insurance. Trends in those without insurance or less coverage are expected to be more alarming given the limitation in access to care. There were significant disparities by sex and race and ethnicity that may inform stakeholders for targeted interventions and resource allocation to curb the surging burden of ALD during pandemic. (Table Presented)

2.
Gastroenterology ; 162(7):S-1222, 2022.
Article in English | EMBASE | ID: covidwho-1967424

ABSTRACT

Background: Data have shown an increase in alcohol use during the COVID-19 pandemic in North America. While the total number of emergency department (ED) visits decreased during the early pandemic, some studies show that the proportion of alcohol-associated visits increased during this time. There is otherwise a paucity of data on how potentially increased alcohol use during the pandemic has affected healthcare utilization and patient outcomes, especially in patients with liver disease. Methods: Clinical records from a tertiary hospital in Ontario, Canada were reviewed for all adult patients encounters in the ED, urgent care, or inpatient setting for alcohol-associated reasons between April 2019 and October 2019 (pre-pandemic cohort) and between April 2020 and October 2020 (pandemic cohort). Data collected included: age, sex, marital status, rurality and socioeconomic status (by postal code-linked national census data), medical history, alcohol consumption habits, use of medications for alcohol use disorder, alcohol-associated diagnosis (based on ICD-10 code), need for intensive care unit admission, consultations made, discharge disposition, and laboratory results. Bivariate chi-squared analysis was performed to compare data from the pre-pandemic and pandemic cohorts. Results: 528 records in the pre-pandemic cohort and 490 records in the pandemic cohort were ed and summarized (Tables 1 and 2). As compared with the pre-pandemic cohort, patients during the pandemic presenting with alcohol-associated diagnoses were older (43 years, IQR 31-57 vs. 38 years, IQR 24-55;p<.001), more likely to be male (66% vs. 55%;p=.001), have a prior history of habitual heavy alcohol use or alcohol use disorder (77% vs. 63%;p<.001), have a history of a psychiatric disorder (56% vs 46%;p=.003), and to have been previously prescribed medication for alcohol use disorder (18% vs. 5%;p<.001). In the pandemic cohort, there was a greater proportion of encounters for alcohol withdrawal (32% vs. 22%;p=.001), a lower proportion of encounters for alcohol intoxication (46% vs. 56%;p<.001), and a similar proportion of encounters for alcohol-associated liver disease (8% vs. 7%;p=.651) compared to the pre-pandemic cohort. Conclusion: Our data show differences in patient characteristics for patients presenting to hospital for alcohol-associated reasons during the COVID-19 pandemic. As compared with the year before the pandemic, patients were older, more often male, and more likely to have history of psychiatric disorders or heavy alcohol use. One concerning finding was a significant rise in alcohol withdrawal, which could potentially be due to increased consumption of alcohol during the pandemic. These data raise concern for an increase in prevalence of alcohol-associated liver disease in the future, highlighting the need for enhanced alcohol addiction services. (Table Presented)

3.
Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine ; 77(sup1):1-33, 2022.
Article in English | EMBASE | ID: covidwho-1886341
4.
Psychology of Men & Masculinities ; : 6, 2022.
Article in English | Web of Science | ID: covidwho-1886200

ABSTRACT

Public Significance Statement The study examined men's conformity to specific masculinity norms to predict their adherence to Centers for Disease Control and Prevention (CDC) recommendations for combatting COVID-19 and their attitudes toward mask wearing. The findings can aid in public health efforts to improve men's participation in combatting the pandemic and future public health crises. The study examined men's conformity to masculine norms as related to adherence to Centers for Disease Control and Prevention (CDC) recommendations for mitigating the spread of COVID-19 as well as men's attitudes toward mask wearing. Five hundred eighty nine participant men, predominantly White and heterosexual, completed the 10-15 min anonymous online survey through Prolific. After controlling for demographics, results indicated that the masculine norms of emotional control and power over women were related to less adherence to CDC recommendations;and that self-reliance, power over women, and heterosexual self-presentation were related to more negative attitudes toward mask wearing. Limitations and future research such as improving men's participation in combatting COVID-19, and other public health crises, by addressing men's specific salient masculine norms when developing and implementing public health outreach and prevention are discussed.

5.
Alcohol Clin Exp Res ; 46(7): 1306-1312, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1846159

ABSTRACT

BACKGROUND: When evaluating an emergency department (ED) patient who presents with suicidal ideation, it is a common practice to wait until the patient's ethanol level is known or calculated to be less than 80 mg/dl to evaluate patient safety. We know of no study that establishes an association between the degree of alcohol intoxication based on a blood alcohol level (BAL) and reported suicidal ideation (SI) upon recovery. METHODS: We conducted a retrospective review of patients evaluated in a Midwestern ED for the calendar year 2017. Cases were selected if they had a psychiatric social work consult and a blood alcohol level drawn while in the ED. Patients were selected on the same 2 days each week throughout the year to meet the sample size requirements of the study, resulting in 1084 cases for review. Chi-square analysis was used to evaluate the relationship between suicidal ideation and alcohol intoxication as defined by a BAL ≥80 mg/dl. RESULTS: Among patients presenting with suicidal ideation and a concurrent BAL ≥80 mg/dl, 69% no longer reported suicidal ideation when their BAL was <80 mg/dl, compared to 38% for patients without a positive BAL on presentation (chi-square, p = 0.000012). CONCLUSION: Our data show that patients presenting to the ED with complaints related to suicidal behavior who have a BAL ≥80 mg/dl are more likely to no longer endorse having suicidal ideation once their BAL is < 80 mg/dl than patients with similar presenting complaints and no alcohol intoxication. This finding supports the common ED practice of re-assessing suicidal ideation among individuals who are initially intoxicated once their BAL has decreased below 80 mg/dl.


Subject(s)
Alcoholic Intoxication , Alcoholism , Alcoholic Intoxication/diagnosis , Alcoholic Intoxication/epidemiology , Alcoholic Intoxication/psychology , Blood Alcohol Content , Emergency Service, Hospital , Humans , Retrospective Studies , Suicidal Ideation
6.
Drug Alcohol Depend ; 228: 109062, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1439974

ABSTRACT

BACKGROUND: Recent data suggest that the COVID-19 pandemic and associated restrictions may have influenced alcohol use and promoted addictive behavior. We aimed to investigate the impact of the pandemic on acute alcohol intoxication (AAI) in France. METHODS: We identified all hospital stays related to alcohol abuse in 2018-2020. Differences in number of hospitalizations between 2019 and 2020 were tested using Poisson regressions. Differences between observed and expected deliveries of drugs used in alcohol dependence in 2020 were also studied. RESULTS: There was a decrease in the number of hospitalizations for AAI between 2019 and 2020 (-9677[-11·4%],RR:0·89[0·88-0·89]). This decrease was observed among men and women of all age groups, except women ≥ 85 years. We observed an increase in in-hospital mortality during 2020 and more hospitalizations for AAI with certain medical complications, especially during the first 2020 lockdown. There was a drop in observed deliveries of drugs used in alcohol dependence during the first 2020 lockdown. CONCLUSIONS: The decrease in the number of hospitalizations for AAI in 2020 could be explained by several factors: fewer available hospital beds due to COVID-19, individuals with AAI delaying or avoiding medical care due to COVID-19 fears, and decreases driven by younger age groups returning to live with parents and socializing less. While alcohol consumption patterns have changed with the implementation of social distancing measures and lockdowns, the increase in mortality and the share of hospitalizations with complications suggest that these measures had an impact on event severity in a context of strained access to healthcare.


Subject(s)
Alcoholic Intoxication , Alcoholism , COVID-19 , Aged, 80 and over , Alcoholic Intoxication/epidemiology , Alcoholism/epidemiology , Communicable Disease Control , Female , Humans , Male , Pandemics , SARS-CoV-2
7.
J Adolesc Health ; 69(6): 905-909, 2021 12.
Article in English | MEDLINE | ID: covidwho-1401560

ABSTRACT

PURPOSE: The association between acute alcohol intoxication among adolescents and the COVID-19 lockdown has been studied previously in Trieste, Italy. They recommended that emergency services should be prepared for a potential peak of alcohol intoxication-related emergencies among adolescents as a result of the COVID-19 lockdown. Therefore, this study investigated the influence of the COVID-19 pandemic on the prevalence of acute alcohol intoxication among adolescents in the Netherlands. METHODS: To determine both the prevalence and characteristics of adolescents admitted for acute alcohol intoxication in 2019-2020, a retrospective cohort study was conducted. All adolescents <18 years of age admitted for acute alcohol intoxication in the 12 participating hospitals in the Netherlands in 2019-2020 were included. Adolescents were divided in periods before, during, and subsequent to the first COVID-19 lockdown and the beginning of the second lockdown, in comparison with the same periods in 2019. RESULTS: The prevalence of acute alcohol intoxication among adolescents decreased by 70% during the first lockdown (March 16-May 31, 2020) compared with the period before lockdown (January 1-March 15, 2020). Between the first lockdown phase and the reopening period (June 1-October 14, 2020), the prevalence significantly increased. CONCLUSIONS: This study demonstrates that COVID-19 lockdown led to a decrease in acute alcohol intoxication among adolescents. This decrease is multifactorial, including the closure of bars/restaurants, sport clubs, schools and increased parental supervision due to obligatory working from home of parents. Based on the findings, this specific population requires close monitoring, especially in the reopening phases.


Subject(s)
Alcoholic Intoxication , COVID-19 , Adolescent , Alcoholic Intoxication/epidemiology , Communicable Disease Control , Humans , Pandemics , Retrospective Studies , SARS-CoV-2
8.
J Clin Med ; 9(7)2020 Jul 06.
Article in English | MEDLINE | ID: covidwho-640481

ABSTRACT

BACKGROUND: Binge drinking and other forms of ethanol abuse are, when present, a serious problem in preteens and adolescents worldwide. AIM: The present study has analyzed the trend in alcohol-related intoxications requiring the hospitalization of children, adolescents and young adults aged less than 21 years in Slovenia in the 1999-2018 period. METHODS: We performed a retrospective study on patients discharged after hospitalizations due to mental and behavioral disorders due to acute alcohol intoxication (MBDAAI) or hospitalizations due to the toxic effects of alcohol (TEA We considered three groups: children (aged 10-14), adolescents (aged 15-19) and young adults (20-21 years old). Hospitalization rates and time trends were analyzed using joinpoint regression to obtain the annually calculated age- and sex-specific rates and the annual percentage of change (APC). RESULTS: Considering a total of 2912 MBDAAI-hospitalizations, 15-19-year-old subjects showed a significantly higher hospitalization rate compared to the immediately younger and older age groups and a significant increase in hospitalization rates in the period 1999-2011, followed by a significant decrease. Considering 1143 TEA-hospitalizations, we observed a continuous decrease in the hospitalization rates for children and young adults and, conversely, a continuous even if less than significant increase for adolescents aged 15-19. CONCLUSIONS: Alcohol consumption in Slovenian children and adolescents is a highly important health concern. Special attention to public health problem of severe alcohol abuse requiring hospitalization in children and adolescents is needed, especially with possible crisis of SARS-CoV-2/Covid-19 situation.

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