A Retrospective Analysis Of Outcomes Amongst Covid-19 Patients With Acute Hepatitis Receiving N-Acetylcysteine Therapy In A Safety Net Hospital

were enforced in California (3/19/2020).The subset of patients evaluated for AH was further characterized.Results: Between 09/2019 and 08/2020, 290 hospitalized patients were evaluated for LT.From 09/2019 to 01/2020, 24 to 34 inpatient LT evaluations were performed per month.The numbers declined surrounding the onset of COVID-19 pandemic: from February through April, 18, 15, and 9 inpatient evaluations were performed respectively each month.However, by May 2020, numbers returned to their pre-COVID-19 baseline (Figure 1).In the prespecified study period, 56 (19.3%) patients underwent LT evaluation for AH.Their mean age was 43.4 years.There were 29 men (51.7%) and the majority were White (n=29, 51.7%), followed by Latinx (n=19, 32.1%).29 patients (51.7%) were on hemodialysis.The mean total bilirubin was 24.0 mg/dL.The proportion of LT evaluations performed for AH increased from 49.4% before the stay-at-home order to 82.4% (p-value=0.01) in April 2020 immediately following it.This proportion promptly returned to baseline in May (Figure 2).Still, a minority of all patients with AH ultimately underwent LT or listing (n=8, 16%).Conclusion: LT evaluation practices for hospitalized patients changed in the early stages of the COVID-19 pandemic but returned to the pre-COVID-19 baseline by May of 2020 following improved understanding of COVID-19 and implementation of hospital practices.Hepatologists should remain vigilant and counsel their patients of alcohol misuse during the pandemic, especially given increases during the Fall of 2020.