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The impact of the coronavirus disease 2019 (COVID-19) outbreak on hospital admissions for alcohol-related liver disease and pancreatitis: a time-series analysis

Background During the coronavirus disease 2019 (COVID-19) pandemic, there have been health concerns related to alcohol use and misuse. Therefore, the World Health Organization cautioned that alcohol consumption during the pandemic might have a negative impact. The aim of this study was to examine the population-level change in cases of alcohol-related liver disease and pancreatitis that required admission during the COVID-19 outbreak. Methods We included patients aged 18 years or older who were hospitalized between July 2018 and June 2020 using Diagnostic Procedure Combination data, an administrative database in Japan, and counted the admission cases whose primary diagnosis was alcohol-related liver disease or pancreatitis. We defined the period from April 2020, when the Japanese government declared a state of emergency, as the beginning of the COVID-19 outbreak. The rate ratio (RR) of admissions with alcohol-related liver disease or pancreatitis per 1,000 admissions was tested using interrupted time series analysis. In addition, excess admissions for alcohol-related liver disease or pancreatitis were calculated. Results Overall admissions were 3,026,389 cases, and a total of 10,242 admissions for alcohol-related liver disease or pancreatitis occurred from 257 hospitals. The rate of admissions per 1,000 admissions during the COVID-19 outbreak period (April 2020 to June 2020) had a 1.2 times increase compared with the pre-outbreak period (July 2018 to March 2020) for cases of alcohol-related liver disease or pancreatitis (RR: 1.22, 95%Confidence interval [CI]: 1.12 to 1.33). The COVID-19 pandemic caused about 214.75 (95%CI: 178.78 to 249.72) excess admissions for alcohol-related liver disease or pancreatitis based on predictions from our model. Conclusion The COVID-19 outbreak might have resulted in increased hospital admissions for alcohol-related liver disease or pancreatitis.