S1300 COVID-19 Impact on Alcohol-Related Cirrhosis and Nonalcoholic Steatohepatitis-Related Cirrhosis on Hospital Admissions

American Journal of Gastroenterology(2022)

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Abstract
Introduction: The COVID-19 pandemic has significantly disrupted the healthcare system globally. Patients with alcohol-related and nonalcoholic steatohepatitis (NASH)-related cirrhosis often have multiple comorbidities, and managing these comorbidities is an important step in minimizing disease progression.The purpose of our study was to analyze how the pandemic affected patients with alcohol-related and NASH cirrhosis and NASH cirrhosis in the first year of the pandemic. Methods: We used the Vizent database clinical database to collect data from 809 United State hospitals from March 2019- March 2021. The pre-pandemic period was defined as March 2019-February 2020 and the post-pandemic period was defined as March 2020-March 2021. Patients with a principal diagnosis of Alcoholic cirrhosis or NASH cirrhosis were included in our study. Patients < 18 years of age and those that required hospice, rehabilitation, or nursing facility placement were excluded. The total number of hospital admissions, the length of stay in days (LOS), and mortality were compared between the pre-pandemic and post-pandemic period. Results: Pre-pandemic, patients with a diagnosis of Alcohol-related cirrhosis had an observed 118,630 admissions, 7.41 mean LOS, 6,414 cases with 1 or more complication, 8,164 observed deaths with a mortality index of 1.01. Post-pandemic, patient's diagnosed with Alcohol-related cirrhosis had an observed 121,613 admissions, 7.70 mean LOS in days, 7,185 cases with 1 or more complication, 9,989 observed deaths and a mortality index of 1.05. Pre-Pandemic patients with a diagnosis of NASH cirrhosis had an observed 51,033 admissions, 7.27 mean LOS, 2,848 cases with 1 or more complication, and 2,535 observed deaths and mortality index of 0.91. Post-pandemic, patient's diagnosed with NASH cirrhosis had an observed 51,117 admission, 7.67 mean LOS, 2,951 cases with 1 or more complication, and 3,077 observed deaths with a mortality index of 0.95. Both groups showed statistically significance increase in number of cases, LOS and observed deaths Post-pandemic (P < .01) Conclusion: The data from our study suggests that patients with a history of both Alcohol-related cirrhosis and NASH cirrhosis were negatively impacted by COVID-19 pandemic. Our data revealed that patients with a history of both Alcohol-related cirrhosis and NASH cirrhosis were at a high risk of disease progression as well as morbidly and morality and will need aggressive clinical follow up to prevent further progression of disease (Table).
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Key words
cirrhosis,alcohol-related,steatohepatitis-related
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