Coronavirus Disease 2019 Hangover: A Rising Tide of Alcohol Use Disorder and Alcohol-Associated Liver Disease
Coronavirus Disease 2019 Hangover: A Rising Tide of Alcohol Use Disorder and Alcohol-Associated Liver Disease
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DOI：
10.1002/hep.31307
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发表时间：
2020-09-01
期刊：
影响因子：
13.5
通讯作者：
Schiano, Thomas D.
中科院分区：
文献类型：
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作者：
Da, Ben L.;Im, Gene Y.;Schiano, Thomas D.
2019冠状病毒病（COVID-19）大流行自2019年11月开始以来已对全球产生巨大影响。然而，人们担心COVID-19大流行不会平等影响所有人，部分人群将特别脆弱。与肝病相关，酒精使用障碍（AUD）和酒精相关性肝病（ALD）患者可能是受影响最严重的人群。其原因包括由于免疫系统受抑制和高风险的潜在合并症而导致的严重COVID-19感染的风险较高，COVID-19对肝脏的损害性影响，无法与提供者进行定期访问，医院资源转移，以及社会隔离导致心理失代偿和饮酒增加或复发。因此，我们担心酒精复发、因失代偿性ALD入院以及COVID-19大流行后新诊断的AUD/ALD患者数量将急剧上升。提供者及其机构应该实施先发制人的战略，如远程医疗和积极的病人外展计划，现在来遏制这一预期的问题。肝移植（LT）中心应适应大流行，考虑宽大处理一些LT候选人与ALD谁不能获得适当的酒精治疗，由于目前的情况。总之，COVID-19大流行可能对AUD/ALD患者尤其不利，现在需要采取行动限制这一预期问题的范围。
The coronavirus disease 2019 (COVID-19) pandemic has had a tremendous global impact since it began in November of 2019. However, there are concerns that the COVID-19 pandemic will not affect all equally and that some populations will be particularly vulnerable. Relevant to liver disease, patients with alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) may be among the populations that are the most severely impacted. The reasons for this include being at a higher risk of severe COVID-19 infection due to a depressed immune system and high-risk underlying comorbidities, the injurious effect of COVID-19 on the liver, the inability to attend regular visits with providers, diversion of hospital resources, and social isolation leading to psychological decompensation and increased drinking or relapse. As a result, we fear that there will be a dramatic rising tide of alcohol relapse, admissions for decompensated ALD, and an increase in newly diagnosed patients with AUD/ALD post-COVID-19 pandemic. Providers and their institutions should implement preemptive strategies such as telehealth and aggressive patient outreach programs now to curb this anticipated problem. Liver transplantation (LT) centers should adapt to the pandemic by considering leniency to some LT candidates with ALD who cannot access appropriate alcohol treatment due to the current situation. In conclusion, the COVID-19 pandemic will likely be especially detrimental to patients with AUD/ALD, and actions need to be taken now to limit the scope of this anticipated problem.