Waiting-list registrations and liver transplants for alcoholic hepatitis (AH) have increased, exceeding the forecasted volumes, in association with increasing retail alcohol sales during the COVID-19 pandemic, according to a study published online Oct. 26 in JAMA Network Open.

Maia S. Anderson, M.D., from the University of Michigan in Ann Arbor, and colleagues examined national changes in waiting-list registration and liver transplantation for alcohol-associated liver disease and the association with alcohol sales during the pandemic. The analysis included data from the United Network for Organ Sharing Standard Transplant Analysis and Research file for new waiting-list registrations and primary deceased donor liver transplants (DDLTs) for U.S. adults (Jan. 1, 2016, through Jan. 31, 2021).

The researchers found a total of 51,488 new waiting-list registrations and 32,320 DDLTs during the study period. During the COVID-19 period (March 2020 to January 2021), there was a significant increase in the proportions of waiting-list registrations and DDLTs for AH versus the same period pre-COVID-19. During the COVID-19 period, there was an overall reduction in waiting-list registration and DDLT at the start of the pandemic (March to May 2020), but from June 2020 to January 2021, there were sharp increases in volumes of waiting-list registrations and DDLTs for AH. This increase exceeded forecasted values by a mean of 59.5 percent in waiting-list registrations and 62 percent in DDLTs. Both a temporal association and a positive correlation were seen between increasing waiting-list registrations and DDLTs for AH and increasing retail alcohol sales. Trends for alcohol-related cirrhosis and non-alcohol-associated liver disease remained unchanged.

"This study provides evidence for an alarming increase in AH associated with increasing alcohol misuse during COVID-19 and highlights the need for public health interventions around excessive alcohol consumption," the authors write.