Emergency department visits for alcohol-related illnesses in the COVID-19 pandemic

ABSTRACT

Background: In March-April 2020, the New York City (NYC) metropolitan area faced one of the largest COVID-19 outbreaks in the world. During the subsequent citywide and nationwide lockdowns, national alcohol sales reported a 54% increase. We attempted to determine whether the increase in alcohol use led to increase volume of emergency department (ED) visits for alcohol-related illnesses. Methods: Coding data from May 2019 to March 2021 for alcohol-related illnesses, including intoxication, independence, withdrawal, and alcoholic liver disease from six teaching hospitals within the Northwell Health System from three geographic regions was reviewed. The six hospitals represent the region connecting Queens and Long Island (Gr. A), the borough of Staten Island (Gr. B), and the borough of Manhattan (Gr. C). Results: The number of patients that visited the ED for alcohol-related illnesses was 7,343 during the 11 months before April 2020. This number decreased to 5,056 during the 11 months after April 2020, a 31% decrease. Individually, the mean±SD of monthly volume significantly decreased from 290±41 to 174±27 (P<0.0001) in Gr. C and from 211±29 to 132±2 (P<0.0001) in Gr. B, but insignificantly decreased in Gr. A from 167±16 to 154±14 (P=0.65). The monthly numbers at the three hospital groups are depicted in image attached. In Gr. A, the monthly volume of cases was unvarying during the 11 months before April 2020 and was essentially unchanged during the pandemic (probability of difference in trend = 0.29), after showing a drop in April corresponding with New York State's severe COVID-19 outbreak. A similar drop during April also occurred in Gr. B and C. In Gr. B, the monthly volume of cases partially recovered after April, but resumed its slight insignificant decrease before April (probability of difference in trend = 0.79). In Gr. C, the monthly volume also partially recovered after April, but showed an upward trend, contrasting the decrease prior to the April outbreak (probability of difference in trend <0.0001). Conclusion: Our study showed that the ED visits for alcohol-related illnesses during the COVID-19 pandemic did not increase in these three neighborhoods of NYC. It suggested that communities may have had varied behavioral responses and the differences warrant further investigation. Future research of the impact of COVID-19 on alcohol-related social-medical issues is urged to take such geographic difference into consideration.