Alcohol Poisoning, in the Shadow of a COVID-19 Pandemic: A 5-Year Review of Methanol and Ethanol Toxicity in Mazandaran; North of Iran

Background The onset of the COVID-19 pandemic coincided with the widespread dissemination of misinformation regarding the protective role of alcohol against the virus. This led to a surge in the consumption of illicit alcoholic beverages and a rise in fatal methanol poisonings. Given the high incidence of alcohol poisoning in Mazandaran Province and the lack of comprehensive epidemiological data, this study aimed to examine the trends, characteristics, and outcomes of alcohol poisoning during and after the pandemic. Methods This retrospective cross-sectional descriptive study included all patients diagnosed with alcohol poisoning who were admitted to hospitals affiliated with Mazandaran University of Medical Sciences from 2020 to 2025. Data on demographics, type of alcohol consumed, clinical symptoms, mode of hospital arrival, and outcomes were extracted from hospital and EMS information systems. Chi-square and Fisher’s exact tests were used for categorical variables, while independent t-tests were employed for continuous variables. Results Of the 958 patients, 82.6% were male. The incidence of alcohol poisoning significantly decreased during the post-pandemic period (p = 0.003). Most cases occurred among young adults. Methanol ingestion was associated with a markedly higher mortality rate (29.4% vs. 8.6% for ethanol) and greater incidence of visual impairment. The dialysis rate was 10% in both groups. Logistic regression analysis identified methanol use, non-EMS transport, and lack of pre-hospital treatment as predictors of higher mortality. Interestingly, male gender was associated with better survival outcomes (p = 0.046). Conclusion These findings highlight the urgent need for early warning systems, targeted education for high-risk groups, and broader public awareness regarding the dangers of counterfeit alcohol during biological crises.