Alberta's alcohol-related liver disease hospitalization rates spiked during 1st COVID wave, study shows

Hospitalization rates for alcohol-related liver diseases nearly doubled in Alberta during the first wave of the COVID-19 pandemic as excessive drinking increased, a University of Calgary study shows — and the patients admitted were younger.

The study compared data on all adult Alberta-based patients admitted to hospital between March 2020 and September 2020, to data on admissions between March 2018 and February 2020.

It found that hospital admissions for alcoholic hepatitis in Alberta jumped from 11.6 per 10,000 to 22.1 out of 10,000 over March to September 2020.

The condition is caused by drinking heavily, and can lead to end-stage liver disease, liver transplant or death, the university said.

The study found that the patients being admitted were an average age of 43, instead of the previous average age of 48.

The research was prompted when Dr. Abdel-Aziz Shaheen, an assistant professor at the Cumming School of Medicine who led the study, noticed longer lineups at liquor stores than grocery stores in late March last year.

"It came to my mind that because everyone was staying at home, alcohol consumption was increasing," Shaheen said.

"So I told my colleagues that we have to figure out the impact that the pandemic is having on alcohol consumption and liver damage."

'This is like an iceberg'

In a survey of Canadians aged 35 to 54, nearly one-quarter said their alcohol consumption increased during the first months of the pandemic, said the Canadian Centre on Substance Use and Addiction.

A lack of routine, boredom and stress were reasons for increased drinking.

The U of C's own research was presented at the International Liver Congress, and physicians from England, France and the United States said they had identified similar trends.

Shaheen said he fears that the pandemic restrictions made patients more reluctant to visit the hospital — meaning the issue is likely even more severe.

"There could have been even higher hospitalization numbers, but due to the restrictions in place during the first wave of COVID-19, people suffering from alcoholic hepatitis may have chosen not to go to the hospital," Shaheen said.

"This is like an iceberg; we're only seeing the tip of it — the very sick people. The biggest problem is if you are drinking and you exceed the recommendations, you are causing damage."

Shaheen said that alcohol-related, severe inflammation of the liver can't be reversed by a drug.

"What we do is comprehensive approach to behavioural change and educating people on safe amount of drinking," he said.

To him, that means recommending people follow the Canadian guidelines for low-risk alcohol drinking.

Shaheen and U of C researchers will continue to analyze the data until 2022, so they can analyze the other waves of the pandemic.

"We are just seeing the first wave of patients with acute problems related to exceeding alcohol consumption. And I think in the next few months or years to come, we will see the real impact of that."

Alberta Health Services offers an addiction helpline that is available provincewide by calling 1-866-332-2322.