Severe alcohol-related liver disease admissions post-COVID-19 lockdown: canary in the coal mine?

Cargill, Zillah; Kattiparambil, Sajith; Hansi, Navjyot; Barnabas, Ashley; Shawcross, Debbie L.; Agarwal, Kosh

doi:10.1136/flgastro-2020-101693

Cited by 17 publications

(23 citation statements)

References 1 publication

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“…For example, hospitalizations for alcohol-associated liver disease and alcohol-related pancreatitis in Japan increased by 20% during the pandemic [27] . Studies from Canada and England also reported a near doubling of hospital admissions for AH after the onset of the COVID-19 pandemic [28 , 29] .…”

Section: Impact On Epidemiology Of Alcohol-associated Liver Diseasementioning

confidence: 97%

Covid-19 and alcohol associated liver disease

Deutsch‐Link

Curtis²,

Singal³

2022

Digestive and Liver Disease

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Section: Impact On Epidemiology Of Alcohol-associated Liver Diseasementioning

confidence: 97%

Covid-19 and alcohol associated liver disease

Deutsch‐Link

Curtis²,

Singal³

2022

Digestive and Liver Disease

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“…Single-centre observations in the UK have also shown that referrals for alcoholic liver disease (ALD) and the proportion of critically unwell inpatients with ALD (but without COVID-19) more than doubled in June 2020 compared with June 2019 (ref. 173 ). The upsurge in harmful drinking, alongside barriers to cessation services and the association between ALD and COVID-19 mortality (discussed earlier) is of major concern and suggests that alcohol advice should be central to the health messages delivered to patients and the general public during the pandemic.…”

Section: Covid-19 Pandemic and Patient Behavioursmentioning

confidence: 99%

COVID-19 and liver disease: mechanistic and clinical perspectives

Marjot

Webb

Barritt

et al. 2021

Nat Rev Gastroenterol Hepatol

331

393

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Our understanding of the hepatic consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its resultant coronavirus disease 2019 (COVID-19) has evolved rapidly since the onset of the pandemic. In this Review, we discuss the hepatotropism of SARS-CoV-2, including the differential expression of viral receptors on liver cell types, and we describe the liver histology features present in patients with COVID-19. We also provide an overview of the pattern and relevance of abnormal liver biochemistry during COVID-19 and present the possible underlying direct and indirect mechanisms for liver injury. Furthermore, large international cohorts have been able to characterize the disease course of COVID-19 in patients with pre-existing chronic liver disease. Patients with cirrhosis have particularly high rates of hepatic decompensation and death following SARS-CoV-2 infection and we outline hypotheses to explain these findings, including the possible role of cirrhosis-associated immune dysfunction. This finding contrasts with outcome data in pharmacologically immunosuppressed patients after liver transplantation who seem to have comparatively better outcomes from COVID-19 than those with advanced liver disease. Finally, we discuss the approach to SARS-CoV-2 vaccination in patients with cirrhosis and after liver transplantation and predict how changes in social behaviours and clinical care pathways during the pandemic might lead to increased liver disease incidence and severity.

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“… 53 Following lifting of the lockdown and increased availability and sale of alcohol, a center from the UK reported doubling of admissions due to ALD and an increase in the proportion of patients with severe alcoholic hepatitis and alcohol-related acute-on-chronic liver failure (ACLF). 55 …”

Section: Liver Manifestations Of Covid-19mentioning

confidence: 99%

Coronavirus Disease-2019 (COVID-19) and the Liver

Elhence¹,

Vaishnav²,

Biswas³

et al. 2021

Journal of Clinical and Translational Hepatology

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Within a year of its emergence, coronavirus disease-2019 (COVID-19) has evolved into a pandemic. What has emerged during the past 1 year is that, apart from its potentially fatal respiratory presentation from which the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) derives its name, it presents with a myriad of gastrointestinal (GI) and liver manifestations. Expression of the angiotensinconverting enzyme-2 (ACE-2) receptor throughout the GI tract and liver, which is the receptor for the SARS-CoV-2, may be responsible for the GI and liver manifestations. Besides acting directly via the ACE-2 receptor, the virus triggers a potent immune response, which might have a role in pathogenesis. The virus leads to derangement in liver function tests in close to 50% of the patients. The impact of these derangements in patients with a normal underlying liver seems to be innocuous. Severe clinical presentations include acute decompensation and acute-on-chronic liver failure in a patient with chronic liver disease, leading to high mortality. Evolving data suggests that, contrary to intuition, liver transplant recipients and patients with autoimmune liver disease on immunosuppression do not have increased mortality. The exact mechanism underlying why immunosuppressed patients fare well as compared to other patients remains to be deciphered. With newer variants of COVID-19, which can spread faster than the original strain, the data on hepatic manifestations needs to be updated to keep a step ahead of the virus.

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Severe alcohol-related liver disease admissions post-COVID-19 lockdown: canary in the coal mine?

Cited by 17 publications

References 1 publication

Covid-19 and alcohol associated liver disease

Covid-19 and alcohol associated liver disease

COVID-19 and liver disease: mechanistic and clinical perspectives

Coronavirus Disease-2019 (COVID-19) and the Liver

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