Liver disease hospitalizations increased as drinking skyrocketed during pandemic

In early 2020, when the country went into lockdown and retreated to their homes to isolate, liquor stores remained open. A University of Calgary researcher was curious what that meant for alcohol consumption. He soon discovered it was on the rise along with the serious health consequences that come with excessive drinking.

From March to September 2020, liver disease hospitalizations of alcoholic hepatitis, which is caused by excessive drinking, rose by 90.5 per cent during the first wave of the COVID-19 pandemic. According to a study led by Dr. Abdel-Aziz Shaheen, MD, assistant professor at the Cumming School of Medicine, University of Calgary, the increased hospitalizations coincided with an increase in liquor sales, which resulted in more alcohol consumption.

Just under 25 per cent of Canadians aged 35 to 54 said their alcohol consumption increased during the opening months of the pandemic, citing lack of regular schedule, boredom and stress as their reasons for increased drinking, according to a study conducted by the Canadian Centre on Substance Use and Addiction.   

"I remember noticing that lineups for some liquor stores were longer than lineups for grocery stores during the pandemic. It came to my mind that because everyone was staying at home, alcohol consumption was increasing, so I told my colleagues that we have to figure out the impact that the pandemic is having on alcohol consumption and liver damage," says Shaheen.

Hospitals see increase  

The study found that hospitalization rates for alcoholic hepatitis nearly doubled from 11.6/10,000 admissions pre-pandemic to 22.1/10,000 admissions. Patients admitted for alcoholic hepatitis during the pandemic were found to be younger, with the average age being 43, compared to 48 before the pandemic. While the study focused on Alberta-based patients, the data was presented at the International Liver Congress, and physicians from England, France, and the United States saw similar trends developing in their jurisdictions.

"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. 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," says Shaheen. 

Alcohol hepatitis consequences and prevention

Alcoholic hepatitis is a serious, debilitating condition that can lead to end stage liver disease, liver transplant or death. However, people often don’t realize the damage being caused inside their body.

Symptoms can include fatigue and a general feeling of a hangover, but can worsen to include yellowing of the skin, severe abdominal pain, bleeding and fluid accumulation in the stomach. During the pandemic, 25 per cent of Canadians reported drinking above Canada’s low-risk alcohol drinking guidelines which state drinking no more than 10 drinks a week for females and 15 drinks a week for males.

If caught early enough the condition can be reversed. People can change their behaviour and lifestyles by drinking less, which will allow the liver and other vital organs to regenerate and prevent the need for hospitalization, and even transplant, when the patient is older.

This study was supported by a Canadian Institutes of Health Research Project Grant. Dr. Shaheen and his colleagues have received additional support to keep analyzing the data until 2022, meaning they will be able to analyze the other waves of the pandemic.