Liver diseases on the rise during COVID-19 pandemic

Posted at 2:52 PM, Feb 25, 2021

KANSAS CITY, Mo. — Doctors are sounding the alarm on a concerning crisis happening side-by-side with the pandemic.

Alcoholic liver disease was already trending in the wrong direction in the United States before the pandemic.

"I’d say over the last five to 10 years the incidence of alcoholic cirrhosis has increased as well as the age we're seeing it at. We listed a 20 something-year-old just a couple of weeks ago for transplant," said Dr. Tim Schmitt, the University of Kansas Health System's transplant director.

Stay-at-home orders arrived in March, and with it, what doctors call an available coping mechanism.

"I know a guy who owns a liquor store and he said his rate of liquor sale in the months after the shutdown in March and April, he sold enough booze in those six weeks that made efforts whole last year's worth of sales," Dr. Schmitt said.

Taken together, the pandemic and an already concerning increase in alcoholic liver disease have created an adjacent health crisis. Doctors have seen a dramatic increase in cases since last March.

"(I) will say from 10 transfers, maybe eight or nine are alcoholic liver disease, so it is incredibly evident that this is a problem. So I mean it's more than 100% increase in cases," said Dr. Laura Alba, the Saint Luke's director of hepatology.

Doctors are also noticing demographic shifts in the patients they’re treating.

"What we're really seeing, which is most concerning, is seeing this in younger and younger patients that are coming through. So these would be healthy people that think that alcohol is relatively safe or they can't get into trouble with alcohol," said Dr. Ryan Taylor, the University of Kansas Health System's director of liver transplant and hepatology.

All three doctors who spoke to 41 Action News said they’re seeing patients in their late 20s and early 30s, more female patients, and severe outcomes.

"The damage that alcohol can do to the liver can be quite significant. So it can range from just a very mild increase in blood tests that can be ordered by your doctor to all the way to seeing damage on a cellular level that can end up leading to signs of end-stage disease," Taylor said.

Doctors say damaged livers lead to an increase in transplants, an area affected deeply by the pandemic.

"It has implications as to how to conserve our patients: who needs to be vaccinated, when they get on the transplant list, how to manage that, what time is the right time to transplant them how to test for COVID-19 right before the transplant, not only for our recipients but on the donors," Alba explained.

She and local health leaders are seeing the intertwined effects of the pandemic and alcohol use, firsthand.

"I did see a person who lost their job from the pandemic and was spending time at home and turned to alcohol for coping mechanisms and within nine months of the pandemic had gone from a pretty normal functional person to now needing a liver transplant," Schmitt said.

As for COVID-19 itself and the vulnerability of the liver, doctors say that is also lethal.

"We have learned from a recent publication that patients with chronic liver disease are three times more likely to die from COVID-19 as a complication as it relates to having ongoing liver disease and COVID-19. So it's definitely a co-factor there," Taylor said, speaking of comorbidity.

There is a singular message from the medical community: drink responsibly.

"We want people to understand that, yes, alcohol has been used safely by people, it can also be a source of severe damage," Taylor said.

This story was published by Dan Cohen at KSHB.