Changes in alcohol‐related hospital visits during COVID‐19 in New York City

Abstract

Background and Aims Increased alcohol consumption has been proposed as a potential consequence of the coronavirus disease 2019 (COVID‐19) pandemic. There has been little scrutiny of alcohol use behaviors resulting in hospital visits, which is essential to guide pandemic public policy. We aimed to determine whether COVID‐19 peak restrictions were associated with increased hospital visits for alcohol use or withdrawal. Secondary objectives were to describe differences based on age, sex and race, and to examine alcohol‐related complication incidence. Design Multi‐center, retrospective, pre–post study. Setting New York City health system with five participating hospitals. Participants Adult emergency department encounters for alcohol use, alcoholic gastritis or pancreatitis or hepatitis, alcohol withdrawal syndrome, withdrawal seizure or delirium tremens. Measurements Age, sex, race, site and encounter diagnosis. Encounters were compared between 2019 and 2020 for 1 March to 31 May. Findings There were 2790 alcohol‐related visits during the 2019 study period and 1793 in 2020, with a decrease in total hospital visits. Of 4583 alcohol‐related visits, median age was 47 years, with 22.3% females. In 2020 there was an increase in percentage of visits for alcohol withdrawal [adjusted odds ratio (aOR) = 1.34, 95% confidence interval (CI) = 1.07–1.67] and withdrawal with complications (aOR = 1.40, 95% CI = 1.14–1.72), and a decline in percentage of hospital visits for alcohol use (aOR = 0.70, 95% CI = 0.59–0.85) and use with complications (aOR = 0.71, 95% CI = 0.58–0.88). It is unknown whether use visit changes mirror declines in other chief complaints. The age groups 18–29 and 60–69 years were associated with increased visits for use and decreased visits for withdrawal, as were non‐white race groups. Sex was not associated with alcohol‐related visit changes despite male predominance. Conclusions In New York City during the initial COVID‐19 peak (1 March to 31 May 2020), hospital visits for alcohol withdrawal increased while those for alcohol use decreased.

Prevention of alcohol withdrawal seizure recurrence and treatment of other alcohol withdrawal symptoms in the emergency department: a rapid review

“…Alcohol withdrawal in the ED has been associated with increased use of critical care resources [9], and frequent ED visits for alcoholrelated presentations have been associated with high relative mortality rates [1,10]. Furthermore, recent studies have demonstrated significant increases in the proportion of alcohol withdrawal-related ED visits during the COVID-19 pandemic, highlighting the rapidly growing burden of alcohol use on EDs across the world [11][12][13][14].…”

Alcohol Use and Its Related Psychosocial Effects during the Prolonged COVID-19 Pandemic in Japan: A Cross-Sectional Survey

“…The average AUDIT scores in males and females were 5.42 ± 6.51 and 2.82 ± 4.80. Based on the classification according to AUDIT scores, the No Problem group (≤ 7) had 9379 (82.1%), the hazardous user group (8)(9)(10)(11)(12)(13)(14) had 1221 (10.7%), and the potential alcoholism group (≥15) had 827 (7.2%) (Table 2) people each. There was a significant difference in age between the three groups (F [2, 11424] = 21.31, p < 0.001, η 2 = 0.004), but the difference did not exceed the lower limit of "small effect size" (i.e., η 2 > 0.010).…”

“…Alcohol use was reported to be one of the factors associated with higher odds of suicidal behavior during the COVID-19 pandemic [5]. Although some studies in Japan, India, the United States, and Czechia reported that alcohol use decreased [6,7] or that alcohol-related problems did not change [8,9] during the COVID-19 pandemic, other studies in the United States and Norway reported that alcohol use or alcohol-related problems increased [10][11][12][13]. Findings from eight European countries indicated that during the first months of the COVID-19 pandemic, alcohol consumption in the upper decile of drinkers increased, as did the prevalence of heavy drinkers, in contrast to the declining consumption in other groups in the sample [14].…”

Lockdown and licensed premises: COVID‐19 lessons for alcohol policy

“…The relationship between emergency service utilisation and alcohol during the pandemic is likely to be highly context specific. It will also hugely depend on the pattern of restrictions in place as illustrated by findings from North America [ 26 , 27 ] outlined earlier and evidence from South Africa finding reduced emergency attendances during total and partial alcohol sales bans [ 56 ].…”

“…In Canada, alcohol‐related visits at accident and emergency departments decreased at the beginning of the pandemic but to a lesser extent than other visits [ 26 ]. In New York City, during the initial COVID‐19 peak in spring 2020, hospital visits for alcohol withdrawal increased while those for alcohol use decreased [ 27 ]. To date, to the best of our knowledge, the impact of COVID‐19 on alcohol‐related ambulance callouts has not been reported.…”