Liver disease-related deaths rise during pandemic

US death rates from alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD) increased at an “alarming” rate during the COVID-19 pandemic, according to new findings presented at the annual meeting of the American Association for the Study of Liver Disease.



Dr Yee Hui Yeo

Between 2019 and 2021, ALD-related deaths increased by 17.6% and NAFLD-related deaths increased by 14.5%, said Yee Hui Yeo, MD, a family physician and liver disease researcher at Cedars-Sinai Medical Center in Los Angeles. press conference before the meeting.

“Even before the pandemic, mortality rates for these two diseases have been increasing, with NAFLD showing an even steeper increase,” he said. “During the pandemic, these two diseases had a significant increase.

Recent Liver Disease Mortality Rates in the United States

Yeo and colleagues analyzed data from the Center for Disease Control and Prevention’s National Vital Statistics System to estimate the age-standardized mortality rate (ASMR) of liver disease between 2010 and 2021, including ALD, NAFLD, hepatitis B, and hepatitis C. Use Forecast. model analyzes based on trends from 2010 to 2019, they predicted mortality rates for 2020-2021 and compared them to observed rates to quantify the pandemic-related differences.

Between 2010 and 2021, there were about 626,000 deaths from chronic liver disease, including about 343,000 deaths from ALD, 204,000 deaths from hepatitis C, 58,000 deaths from NAFLD, and 21,000 deaths from hepatitis B-000.

For ALD-related deaths, the annual percentage change was 3.5% for 2010-2019 and 17.6% for 2019-2021. ASMR observed in 2020 was significantly higher than predicted, at 15.7 deaths per 100,000 people versus 13.0 predicted from the 2010-2019 rate. The trend continued in 2021, with 17.4 deaths per 100,000 people versus 13.4 in the previous decade.

The highest number of deaths from ALD during the COVID-19 pandemic occurred in Alaska, Montana, Wyoming, Colorado, New Mexico, and South Dakota.

For NAFLD-related deaths, the annual percentage change was 7.6% for 2010-2014, 11.8% for 2014-2019, and 14.5% for 2019-2021. ASMR was also higher than predicted, at 3.1 deaths per 100,000 people versus 2.6 in 2020, as well as 3.4 versus 2.8 in 2021.

The highest number of deaths from NAFLD during the COVID-19 pandemic occurred in Oklahoma, Indiana, Kentucky, Tennessee, and West Virginia.

Hepatitis B and C Profits are lost in a pandemic

In contrast, the annual percentage change was -1.9% for hepatitis B and -2.8% for hepatitis C. After the introduction of a new treatment for hepatitis C in 2013-2014, the mortality rate was -7.8% for 2014-2019 , Yeo said.

“However, during the pandemic, we saw that this reduction has become an insignificant change,” he said. “That means our progress over the past 5 or 6 years has already stalled during the pandemic.”

By race and ethnicity, the increase in ALD-related mortality was most pronounced in non-Hispanic whites, non-Hispanic blacks and Alaska Native/American Indians, Yeo said. Alaska Natives and Native Americans had the largest annual percentage change, at 18%, followed by non-Hispanic whites at 11.7% and non-Hispanic blacks at 10.8%. There were no significant differences by race or ethnicity for deaths from NAFLD, although all groups had large increases in recent years.

The largest increase in the number of young adults

By age, the increase in ALD-related mortality was particularly severe in 25-44 year olds, with a 34.6% annual percentage change between 2019-2021, compared to 13.7% for 45-64 year olds and 12.6% for 65 year olds and older

For NAFLD-related deaths, another large increase was seen among 25-44 year olds, with an annual percentage change of 28.1% for 2019-2021, compared with 12% for 65 and older and 7.4% for 45-64 year olds.

By sex, the ASMR increase in NAFLD-related mortality was stable throughout 2010-2021 for both men and women. In contrast, deaths from ALD increased significantly between 2019 and 2021, with an annual percentage change of 19.1% in women and 16.7% in men.

“The increasing trends in mortality for ALD and NAFLD have been quite alarming, with disparities across age, race and ethnicity,” Yeo said.

The study received no funding. Some authors reported research funding, advisory board roles, and consulting fees with various pharmaceutical companies.

This story originally appeared on MDedge.com, part of the Medscape Professional Network.

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