VARIABLE IMPACT OF COVID-19 PANDEMIC ON HOSPITALIZATION FOR ALCOHOL-ASSOCIATED LIVER DISEASE

ABSTRACT

stress. We studied admissions, readmission (RAD) rates, and demographics of ALD patients before and after the onset of the COVID-19 pandemic. Methods: We reviewed the number of hospitalizations before and after the onset of the COVID-19 pandemic for ALD at four teaching hospitals in the Northwell Health System, two bordering New York City to the east (region A) and two in NYC (region B). Coding data of hospital discharges for ALD (alcoholic hepatitis, alcohol-associated cirrhosis, nonspecific alcohol liver disease) during the 14 months between January 2019 and February 2020 (period 1) were compared to those between June 2020 and July 2021 (period 2) for admissions, RAD, and demographics. Data from March to May 2020 were excluded due to New York City lockdown, limited and delayed access to health care due to COVID-19 pandemic. The Fisher's exact test and Mann- Whitney test are used for statistic comparisons. Results: The number of hospitalizations for ALD increased by 32% during the COVID-19 pandemic. However, the increase was only observed in region A, but not in region B (55% vs -1%). With the onset of the pandemic, the median age for ALD admissions decreased by 4.5 years overall, significantly in region B (7.5 years), but not in region A (2 years). In both regions, the percentage of the white race admissions also decreased. No significant difference was observed in the gender distribution, Medicaid insurance status and overall rate of RAD (Table 1). However, the white population had decreased RAD rates from 32% to 17% in region B, the non-white population RAD rates increased from 17% to 31% in region A, and in regions A and B combined (Table 2). Conclusion: Our study shows that admission for ALD increased during the COVID-19 pandemic in areas bordering NYC but not in NYC. These rates differed by race, accompanied with a slight shift to younger age. Our results suggest that observations based on certain communities or regions may not be universally applicable. Future research for the impact of COVID-19 on ALD and other social-economic adaptation should take demographic and geographic variations into consideration. (Table Presented)