Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemic

Introduction and Objectives: The COVID-19 pandemic has resulted in a greater incidence of alcohol-associated liver disease (ALD) and simultaneously magnified health-related inequalities. We evaluated the impact of race and ethnicity on ALD-related hospitalizations in Brazil. Materials and Methods: A...

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Main Authors: Daniel L Heringer, Gabriel P.A. Costa, Jeremy Weleff, Victor Rodrigues, Shreya Sengupta, Akhil Anand
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Annals of Hepatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1665268124005258
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author Daniel L Heringer
Gabriel P.A. Costa
Jeremy Weleff
Victor Rodrigues
Shreya Sengupta
Akhil Anand
author_facet Daniel L Heringer
Gabriel P.A. Costa
Jeremy Weleff
Victor Rodrigues
Shreya Sengupta
Akhil Anand
author_sort Daniel L Heringer
collection DOAJ
description Introduction and Objectives: The COVID-19 pandemic has resulted in a greater incidence of alcohol-associated liver disease (ALD) and simultaneously magnified health-related inequalities. We evaluated the impact of race and ethnicity on ALD-related hospitalizations in Brazil. Materials and Methods: An interrupted time series analysis was used to estimate ALD-related hospitalization in public hospitals in Brazil. Monthly hospitalization rates for 34 consecutive months before and after the point of interruption (March 2020) were calculated using the Sistema de Informações Hospitalares database across four ethnic groups: Black, Pardo, Black, and Pardo combined, and Others (White and Unknown Ethnicity). Results: A total of 84,787 ALD-related hospitalizations were recorded during the study period. The mean age of hospitalized patients was 53 years (SD=12.5); 83.6% were male. Immediately after the start of the pandemic, there was a statistically significant decrease in monthly ALD-related hospitalization rates for the whole population and for all ethnic groups. Subsequently, compared to pre-pandemic rates, there was a statistically significant trend increase in the referred hospitalization rates for the total population (0.065, 95% CI= 0.045 to 0.085, p<0.01), black population (0.0028, 95% CI= 0.006 to 0.050, p<0.05), pardo population (0.077, 95% CI= 0.063 to 0.090, p<0.01), and for black and pardo combined population (0.066, 95% CI= 0.053 to 0.079, p<0.01); however, the increase in hospitalization rates among the Others population (0.059, 95% CI= -0,014 to 0.133, p>0.1) was not statistically significant. Conclusions: The pandemic impacted ALD-related monthly hospitalization rates and disproportionately impacted Black and Pardo populations in Brazil.
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spelling doaj-art-b8dc76159122464f800c1def90ab72712025-08-20T03:20:22ZengElsevierAnnals of Hepatology1665-26812025-01-0130110174210.1016/j.aohep.2024.101742Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemicDaniel L Heringer0Gabriel P.A. Costa1Jeremy Weleff2Victor Rodrigues3Shreya Sengupta4Akhil Anand5Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, SP, Brazil; Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, United StatesFaculdade de Medicina, Universidade de Ribeirão Preto, SP, BrazilDepartment of Psychiatry, Yale University School of Medicine, CT, United States; Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, United States; Department of Psychiatry, Faculty of Medicine &amp; Dentistry, University of Alberta, Edmonton, Alberta, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, CanadaFaculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, RJ 20950-000, BrazilDepartment of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, United StatesDepartment of Psychiatry and Psychology, Cleveland Clinic, Cleveland, United States; Department of Psychiatry, University Hospitals Medical Center, Cleveland, OH, United States; Corresponding author.Introduction and Objectives: The COVID-19 pandemic has resulted in a greater incidence of alcohol-associated liver disease (ALD) and simultaneously magnified health-related inequalities. We evaluated the impact of race and ethnicity on ALD-related hospitalizations in Brazil. Materials and Methods: An interrupted time series analysis was used to estimate ALD-related hospitalization in public hospitals in Brazil. Monthly hospitalization rates for 34 consecutive months before and after the point of interruption (March 2020) were calculated using the Sistema de Informações Hospitalares database across four ethnic groups: Black, Pardo, Black, and Pardo combined, and Others (White and Unknown Ethnicity). Results: A total of 84,787 ALD-related hospitalizations were recorded during the study period. The mean age of hospitalized patients was 53 years (SD=12.5); 83.6% were male. Immediately after the start of the pandemic, there was a statistically significant decrease in monthly ALD-related hospitalization rates for the whole population and for all ethnic groups. Subsequently, compared to pre-pandemic rates, there was a statistically significant trend increase in the referred hospitalization rates for the total population (0.065, 95% CI= 0.045 to 0.085, p<0.01), black population (0.0028, 95% CI= 0.006 to 0.050, p<0.05), pardo population (0.077, 95% CI= 0.063 to 0.090, p<0.01), and for black and pardo combined population (0.066, 95% CI= 0.053 to 0.079, p<0.01); however, the increase in hospitalization rates among the Others population (0.059, 95% CI= -0,014 to 0.133, p>0.1) was not statistically significant. Conclusions: The pandemic impacted ALD-related monthly hospitalization rates and disproportionately impacted Black and Pardo populations in Brazil.http://www.sciencedirect.com/science/article/pii/S1665268124005258Alcohol-associated liver diseaseAlcohol use disorderCOVID-19PandemicHealth inequalitiesRacial disparities
spellingShingle Daniel L Heringer
Gabriel P.A. Costa
Jeremy Weleff
Victor Rodrigues
Shreya Sengupta
Akhil Anand
Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemic
Annals of Hepatology
Alcohol-associated liver disease
Alcohol use disorder
COVID-19
Pandemic
Health inequalities
Racial disparities
title Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemic
title_full Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemic
title_fullStr Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemic
title_full_unstemmed Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemic
title_short Racial and ethnic disparities in alcohol-associated liver disease hospitalizations in Brazil before and after the COVID-19 pandemic
title_sort racial and ethnic disparities in alcohol associated liver disease hospitalizations in brazil before and after the covid 19 pandemic
topic Alcohol-associated liver disease
Alcohol use disorder
COVID-19
Pandemic
Health inequalities
Racial disparities
url http://www.sciencedirect.com/science/article/pii/S1665268124005258
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