Chronic Liver Disease-Related Mortality in Diabetes Before and During the COVID-19 in the United States

Authors

Donghee Kim
Omar Alshuwaykh
Brittany B Dennis
George Cholankeril
Joshua W Knowles
Aijaz Ahmed

Publication Date

1-1-2023

Journal

Digestive and Liver Disease

DOI

10.1016/j.dld.2022.09.006

PMID

36182570

PMCID

PMC9534558

PubMedCentral® Posted Date

9-29-2022

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Male, Humans, Female, United States, Non-alcoholic Fatty Liver Disease, Pandemics, COVID-19, Liver Cirrhosis, Hepatitis C, Hepacivirus, Diabetes Mellitus, Nonalcoholic fatty liver disease, Alcohol-related liver disease, Cirrhosis, Hepatitis

Abstract

BACKGROUND: Global pandemic of COVID-19 represents an unprecedented challenge. COVID-19 has predominantly targeted vulnerable populations with pre-existing chronic medical diseases, such as diabetes and chronic liver disease.

AIMS: We estimated chronic liver disease-related mortality trends among individuals with diabetes before and during the COVID-19 pandemic.

METHODS: Utilizing the US national mortality database and Census, we determined the quarterly age-standardized chronic liver disease-related mortality and quarterly percentage change (QPC) among individuals with diabetes.

RESULTS: The quarterly age-standardized mortality for chronic liver disease and/or cirrhosis among individuals with diabetes remained stable before the COVID-19 pandemic and sharply increased during the COIVD-19 pandemic at a QPC of 8.5%. The quarterly mortality from nonalcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ALD) increased markedly during the COVID-19 pandemic. Mortality for hepatitis C virus (HCV) infection declined with a quarterly rate of -3.3% before the COVID-19 pandemic and remained stable during the COVID-19 pandemic. While ALD- and HCV-related mortality was higher in men than in women, NAFLD-related mortality in women was higher than in men.

CONCLUSIONS: The sharp increase in mortality for chronic liver disease and/or cirrhosis among individuals with diabetes during the COVID-19 pandemic was associated with increased mortality from NAFLD and ALD.

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