The following is a summary of the “Impact of the COVID-19 pandemic on liver disease-related mortality rates in the United States,” published in the January 2023 issue of Hepatology by Gao, et al.

Deaths unrelated to COVID-19 infection have also increased due to the pandemic. The purpose of this study was to use a nationally representative death dataset to assess the influence of the pandemic on the prevalence of liver disease in the United States, namely alcohol-related liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). Liver disease deaths were uncovered using the CDC’s WONDER platform’s National Vital Statistics data and ICD-10 codes. In addition, we used joinpoint and prediction modeling research to compare actual mortality rates in 2020 and 2021 with projections based on trends from 2010 to 2019.

Age-standardized mortality rates (ASMRs) for ALD increased dramatically between 2010-2019 and 2020-2021 (annual percentage change [APC] 3.5% to 17.6%, p 0.01), resulting in a higher observed ASMR (per 100,000 persons) than predicted for 2020 (15.67 vs. 13.04). This increase was seen among the 626,090 deaths attributed to chronic liver disease between 2010 and 2021. (17.42 vs. 13.41). Similarly, the incidence of NAFLD among people with a high risk of developing the disease increased during the pandemic (accelerated progression curve [APC]: 14.5%), but the incidence of hepatitis B and C declined. Importantly, the Overall increase for ALD was highest in non-Hispanic Whites (11.7%), non-Hispanic blacks (10.8%), and Alaska Indians/Native Americans (18.0%) (all P< 0.05), with comparable but less severe findings for NAFLD (4.8%); conversely, rates were stable for non-Hispanic Asians (4.9%) from 2010-2021. 

Increases in ALD ASMR were seen across all age groups after COVID-19, although they were most pronounced in those between the ages of 25 and 44 (APC: 34.6% vs. 13.7% and 12.6% for 45–64 and 65, respectively; all P<0.01). For young people, non-Hispanic Whites, and Alaska Natives/Native Americans, the Risk for ALD and NAFLD rose dramatically during the COVID-19 epidemic.