Last spring’s COVID-19 lockdown saw a significant increase in alcohol-related GI and liver disease consultations, according to a new analysis of hospital system-wide data comparing GI consults in 2020 to those from 2019.

“We were seeing fewer GI consults in general during the lockdown phase because our hospital was overwhelmed by COVID-19 patients,” said Waihong Chung, MD, PhD, lead researcher on the study and a research fellow for the Division of Gastroenterology at the Warren Alpert Medical School of Brown University. “But the proportion of consults of alcohol-related GI and liver diseases were significantly higher, both during the lockdown phase and the reopening phase.”

Dr. Chung and his team analyzed all inpatient GI consults performed at three hospitals during the lockdown (3/23/2020 to 5/10/2020, n = 558) and reopening (6/1/2020 to 7/19/2020, n = 713) phases of the pandemic. Data were then compared with the same time periods during 2019. Researchers found:

• The overall volume of GI consults fell by 27 percent during lockdown.
• Consults for alcohol-related GI and liver disease increased by almost 60 percent.
• After the overall volume of GI consults rebounded to 101 percent during the reopening phase, the proportion of consults for alcohol-related GI and liver diseases remained elevated by 78.7 percent.
• Alcoholic hepatitis consults during the reopening phase increased by 127 percent.

“We see during the lockdown phase, the majority of admissions for alcohol-related GI and liver diseases actually clustered around weeks five, six and seven — the latter half of the lockdown phase,” said Dr. Chung. “I think people were staying at home more and started consuming more alcohol, and in about a month, we saw this huge spike in the consult volume for alcoholic GI and liver disease.”

Dr. Chung cautioned that their study only looked at inpatient consults, which would not capture the large swath of people with alcohol use disorder who do not seek help or may not get admitted.

“We are seeing from our study, there’s maybe a two-fold increase in the prevalence of alcoholic hepatitis, for example; but keep in mind that this is probably an underestimation,” he said. “I certainly believe there are more people out there who are consuming more alcohol and getting sick.”

Dr. Chung and his colleagues next plan to repeat these analyses in outpatients as well as to examine the impact of GI care associated with the increased use of telemedicine since the start of this pandemic.

“Alcoholic liver disease and alcoholic GI disease have exploded as a result of the pandemic, but the problem is, patients are seldom going to volunteer this information,” said Dr. Chung. “There are validated screening questions physicians can ask, such as the CAGE questionnaire that only take a minute to administer and offer reasonable sensitivity and specificity for alcohol use disorders. It’s an important problem, and if we do not screen for it, we cannot help these people.”

Dr. Chung’s oral presentation of “Increased burden of alcohol-related gastrointestinal and liver diseases during the COVID-19 pandemic: A hospital system-wide audit” will take place on Saturday, May 22, at 1:50 p.m. EDT, as part of the AASLD Clinical Science Plenary.