| Sumario: | BACKGROUND: The COVID-19 pandemic has caused significant morbidity and mortality worldwide. During prolonged periods of global lock-down and disruption of clinical services, patients with alcoholic and non-alcoholic cirrhosis had to seek clinical care virtually and reduce their clinic visits. Furthermore, there has been significant increase in alcohol sales. PURPOSE: In our study, we aimed to evaluate the impact of COVID-19 restrictions on patients with alcoholic and non-alcoholic cirrhosis as well as alcoholic hepatitis (AH) who were hospitalized. METHODS: We used validated international clinical classification (ICD-9 and ICD-10) coding algorithms to identify liver-related hospitalizations for non-alcoholic cirrhosis, alcoholic cirrhosis, and AH in the province of Alberta, Canada (population ~4.5 million) between March 2018 and September 2020. We used inpatient and ambulatory care administrative databases linked to the provincial laboratory database to identify our cohort. We defined the AH cohort as patients who had a diagnosis code of AH and possessed both of the following criteria: elevated ALT or AST, and elevated international normalized ratio (INR). We compared post COVID-19 restrictions (April-September 2020) to prior study periods. Joinpoint regression was used to evaluate inflection points in the temporal trends among the three cohorts. RESULT(S): We identified 2,916 hospitalizations for non-alcoholic cirrhosis, 2,318 hospitaliza-tions for alcoholic cirrhosis, and 1,408 AH hos-pitalizations during our study time. Pre- and post-COVID-19 admission characteristics and outcomes for the three cohorts are presented in Table 1. Among alcoholic and non-alcoholic cirrhosis cohorts, there were no significant changes between average monthly admission rate, demographics, LOS, ICU admissions, and in-hospital mortality (Table 1). AH patients had a significant increase in average monthly admission (69.5 vs. 39.6, P < 0.001) with April 2020 being the inflection point. Although AH patients admitted post COVID-19 restrictions were younger (median age 43 vs. 47, P = 0.02), there were no significant differences in admission outcomes pre- and post-COVID-19 among AH cohort. CONCLUSION(S): In this large population-based study, pre- and post-COVID-19 monthly admission rates were stable for non-alcoholic and alcoholic cirrhosis, however, there was a significant increase in AH admissions. As alcohol sales surged during the COVID-19 pandemic, future impact on alcoholic liver disease could be detrimental.
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