Alcohol use disorder and liver injury related to the COVID-19 pandemic

Abstract

Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components. Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte. The liver is the central organ in the metabolism of alcohol, a process that also involves other organs and tissues such as the brain, heart and muscles, but the most relevant organ is the liver. The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes, to cirrhosis and hepatocellular carcinoma. Alcohol abuse frequently leads to liver disease such as steatosis, steatohepatitis, fibrosis, cirrhosis, and tumors. Following the spread of coronavirus disease 2019 (COVID-19), there was an increase in alcohol consumption, probably linked to the months of lockdown and smart working. It is known that social isolation leads to a considerable increase in stress, and it is also recognized that high levels of stress can result in an increase in alcohol intake. Cirrhotic patients or subjects with liver cancer are immunocompromised, so they may be more exposed to COVID-19 infection with a worse prognosis. This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

“…Another fundamental issue is that a potential influence of alcohol use disorder (AUD) on the pattern of liver injury in the case of underlying COVID-19 and possible differences in hepatic manifestation of the disease regarding a previous alcohol abuse history or its absence must be clarified. The inflammatory background of these two conditions appears to be of crucial importance in relation to searching for potential dependencies, even though it can only be speculated which factor is this triggering one: ALD or coronavirus infection [218][219][220]. The data concerning this aspect are rather scarce, nevertheless some attempts to identify the alcoholic background of hepatic complications due to infection with SARS-CoV-2 have already been made.…”

The Microbiota–Gut–Brain Axis: Psychoneuroimmunological Insights

“…Other comorbidities straddling between mood and gastrointestinal disorders are those induced by alcohol use, which has markedly increased during the COVID-19 era; social isolation and external stressors have strengthened this correlation [ 81 ]. Alcohol could affect microbiota, while a healthy microbiota could contribute to a regression of liver pathologies, such as steatosis [ 82 ].…”

Chronic alcohol consumption and COVID‐19 infection risk: A narrative review

“…When considering the death rate of AUD patients before and during the pandemic, the mortality increased by around 20% for both men and women with strongest effects in patients between 25 and 44 years of age (White et al, 2022; Yeo et al, 2022). In addition, numerous studies have reported a reinforced drinking behavior of AUD patients and increased alcohol‐related organ damage in AUD individuals during the pandemic (Hutchison et al, 2022; Kothadia et al, 2022; Marano et al, 2022; Schecke et al, 2022; Tikaria et al, 2022).…”