The impact of the COVID-19 epidemic on hospital admissions for alcohol-related liver disease and pancreatitis in Japan

  1. Hisashi Itoshima
  2. Jung-ho Shin
  3. Daisuke Takada
  4. Tetsuji Morishita
  5. Susumu Kunisawa
  6. Yuichi Imanaka

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Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, there have been health concerns related to alcohol use and misuse. We aimed to examine the population-level change in cases of alcohol-related liver disease and pancreatitis that required admission during the COVID-19 epidemic by interrupted time series (ITS) analysis using claims data. We defined the period from April 2020, when the Japanese government declared a state of emergency, as the beginning of the COVID-19 epidemic. This ITS analysis included 3,026,389 overall admissions and 10,242 admissions for alcohol-related liver disease or pancreatitis from 257 hospitals between July 2018 and June 2020. The rate of admissions per 1000 admissions during the COVID-19 epidemic period (April 2020–June 2020) was 1.2 times (rate ratio: 1.22, 95% confidence interval: 1.12–1.33) compared to the pre-epidemic period. Analyses stratified by sex revealed that the increases in admission rates of alcohol-related liver disease or pancreatitis for females were higher than for males during the COVID-19 epidemic period. The COVID-19 epidemic in Japan might associates an increase in hospital admissions for alcohol-related liver disease and pancreatitis. Our study could support the concern of alcohol consumption and health problems during the COVID-19 pandemic.

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  1. Version published to 10.1038/s41598-021-92612-2
  2. ScreenIT

    SciScore for 10.1101/2020.11.16.20232181: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical considerations: The present study was approved by the ethics committee of Kyoto University (approval number: R0135), and we did not require informed consent because of the use of anonymized data, in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects, as stipulated by the Japanese Government.
    Consent: Ethical considerations: The present study was approved by the ethics committee of Kyoto University (approval number: R0135), and we did not require informed consent because of the use of anonymized data, in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects, as stipulated by the Japanese Government.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Strengths and Limitations: The total case volume was a strength of the study. The total number of hospitalizations was 3,026,389 in 257 hospitals throughout Japan. In contrast, the database had no information about alcohol consumption for each admission case. Therefore, the relationship between individual alcohol consumption and the occurrence of hospital admissions for alcohol-related liver disease or pancreatitis was unclear. Several studies on alcohol consumption have been published since COVID-19 was first reported [5, 15, 16, 17]. However, few studies have examined the association between the pandemic and alcohol-related physical illnesses, such as liver disease and pancreatitis, as of October 14, 2020, including during the 2003 Severe Acute Respiratory Syndrome (SARS) pandemic. Among more than 800 Hong Kong residents who were exposed to the SARS pandemic in 2003, 4.7% of males and 14.8% of females who were current drinkers reported an increase in drinking one year after the SARS pandemic [18]. In addition, the risk of presenting symptoms of alcohol use disorders three years after the SARS pandemic was about 1.5 times higher for affected individuals, such as health care workers in Beijing who worked in quarantine or high-risk wards, compared with unexposed hospital workers [19]. Meaning of the study for clinicians and policymakers: Reports of alcohol consumption during the COVID-19 pandemic have varied. Several studies reported that alcohol consumption increased, but oth...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

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  3. Version published to 10.1101/2020.11.16.20232181v1 on medRxiv