Comment on the "The Pandemic Within the Pandemic: Unprecedented Rise in Alcohol-related Hepatitis During the COVID-19 Pandemic".

We read with great interest the article by Sohal et al.1 It mentioned that the number of patients requiring hospitalization for severe alcohol-related hepatitis had risen sharply during the Coronavirus disease 2019 (COVID-19) pandemic. We strongly agreed with this opinion. As reported in many articles, alcohol-related digestive diseases were raised since alcohol consumption patterns were changed during the COVID-19 pandemic.2–5

There are several reasons for this phenomenon. Firstly, COVID-19 pandemic lockdown and restrictions had caused tremendous disruptions for people. Many people had to stay-at-home because a lot of industries were shuttered or stay-at-home orders, which causing social isolation, loss of nonalcohol activities.2–4,6 Especially for young people, the alcohol increases may be attributed to college campus closures, transitions to purely online education, lack of communication with peers.1 Secondly, COVID-19 led to the economic dislocation, many people’s incomes reduced or even lost jobs while prices rise, which caused financial worry. A survey found that African American suffered higher rates of alcohol-related digestive diseases during the pandemic. Possible causes included lack of a secure environment, job loss, increased poverty, lower education, and health literacy.5 Thirdly, women had more psychological stress and a higher likelihood of developing alcoholic liver disease.3,5 Fourthly, COVID-19 led to a global disruption in medical systems. Many people delayed seeking medical care due to the fear of infecting COVID-19 in medical visiting.1 Medical workers were reallocated since the number of COVID-19 patients rising, many hospitals were already beyond capacity to offer same per-pandemic services and care, such as face-to-face consultation, alcohol-cessation counseling, which might increase alcohol intake reasonably.

COVID-19 has influenced both physical health and mental health, and alcohol-related digestive diseases has had imposed burden on the capacity and cost of strained health care system.1,3,5 It is important for the healthcare to raise attention and awareness to the growing pandemic of alcohol use disorder, and increase health education and prevention for alcohol-related digestive diseases.