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CHANGES IN MORTALITY DUE TO CHRONIC LIVER DISEASES (CLD) DURING THE COVID- 19 PANDEMIC: DATA FROM THE UNITED STATES' NATIONAL VITAL STATISTICS SYSTEM
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AASLD 2022 Nov 4-8
program abstract
Background: Death rates in the U.S. have surged during the COVID- 19 pandemic. The impact of the pandemic on CLD- related mortality has not been fully understood. Our aim was to assess changes in CLD- related mortality in the U.S. during the COVID- 19 pandemic.
Methods: Mortality records from all death certificates filed in the U.S. (2011-2 020) via National Vital Statistics System (NVSS) were utilized. CLD-r elated deaths were classi-fied by the International Classification of Diseases, 10th Revision (ICD- 10) as an underlying or contributing causes of death. CLDs include hepatitis B and C virus (HBV and HCV), alcoholic liver disease (ALD), non- alcoholic fatty liver disease (NAFLD) as well as codes of hepatocellular carcinoma (HCC) or cirrhosis. The 15 leading causes of death were based on the underlying cause of death by Centers for Disease Control and Prevention (CDC). The contribution of each leading cause of death to the total CLD- related deaths was evaluated by dividing change in leading cause of death by change in total CLD-r elated deaths between 2019 and 2020.
Results: The number of deaths in the U.S. in 2020 was 3,370,394 with an in-crease of 18.3% from 2019. The majority of this increase (66.5%) could be attributed to COVID- 19. In 2020, there were 150,543 CLD-related deaths with an increase of 42.4% from 2019 related to COVID- 19. In fact, deaths due to HCC increased by +2.1% and deaths due to cir-rhosis increased by +13.5%. During this period (2019 to 2020), NAFLD-related deaths and ALD-r elated deaths increased by +15.0% and +24.7%; respectively. These represent the largest increases that have been experi-enced since 2011. About a third (33.3%) of this increase in NAFLD-related deaths could largely be explained by COVID-1 9, followed by cirrhosis (25.5%). In contrast, 54.4% increases in ALD- related deaths were from cirrhosis with only 8.6% related to COVID- 19. While HBV- and HCV-related deaths had been declining since 2013, during this period (2019- 2020), HBV- and HCV-r elated deaths increased by +7.3% and +4.3%; respectively. These increases in HCV and HBV- related deaths in 2020 were primarily driven by COVID- 19 (≥85%).
Conclusion: COVID- 19 pandemic has had a major negative impact on CLD- related mortality in the United States.
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