The COVID-19 pandemic has had a major effect on chronic disease trends [1]. According to the former commissioner of the US Food and Drug Administration (FDA), Dr. Robert Califf, the United States can expect a wave of morbidity and mortality from common chronic conditions that will impact society for decades [2]. At the crest of this wave will be cardiometabolic diseases [3].
The United States has seen a declining life expectancy over the past few years despite prior decades of steady progress [3]. This reversal has been attributed to increased deaths from drug overdose, suicide, and cardiovascular disease [3]. Younger people today see a higher risk of obesity, hypertension, and glucose intolerance driven by poor diet and lack of exercise, therefore leading to increased prevalence of cardiometabolic disease [3]. Data indicate that COVID-19 typically presents in a more severe form in patients with pre-existing chronic conditions, such as cardiometabolic disease [1]. These patients are more susceptible to COVID-19 and have a higher mortality rate compared to patients with no comorbid conditions [1]. Factors that relate to the enhanced susceptibility and increased mortality from COVID-19 in these patients include increased expression of the angiotensin-converting enzyme-2 (ACE2) in specific organs, cytokine storm, and certain drug interactions [1]. Data have also suggested that COVID-19 infection can induce chronic disease in previously healthy patients [1]. The net effect of COVID-19 on chronic conditions is excess mortality and a steep drop in the average United States life expectancy by as much as 3 years [3].
The impact of the COVID-19 pandemic on chronic disease trends can even be seen presently as hospitals have reported a drastic increase in alcohol-related admissions for critical diseases like alcoholic hepatitis and liver failure [4]. Before the pandemic, alcohol-related liver disease was a growing problem, with 15 million people diagnosed with the condition in the United States [4]. Over the past decade, hospitalizations due to alcohol-related liver disease has doubled [4]. This trend has been exacerbated by the pandemic — the Keck Hospital of the University of Southern California saw a 30% rise in admissions for alcoholic liver disease in 2020 compared with 2019 [4]. Moreover, hospitals affiliated with the University of Michigan, Northwestern University, Harvard University, and Mount Sinai Health System in New York City have reported up to a 50% increase in admissions for alcoholic liver disease [4].
The pandemic has led to a national increase in alcohol consumption [4]. One study found that rates of alcohol use in spring 2020 were 14% higher than the same period in 2019 [4]. Unemployment, isolation, lack of daily structure, and boredom have all been shown to increase the risk of heightened alcohol use [4]. Women have disproportionately suffered more as the stressors of the pandemic (job stability, parenting, lower wages) have tended to fall more heavily on women’s shoulders [4]. Furthermore, women metabolize alcohol at slower rates than men [4]. As a result, increased incidence of alcoholic liver disease has been seen more heavily in women compared to men [4].
References
- Alyammahi, S., Abdin, S., Alhamad, D. et al. (2021). The dynamic association between COVID-19 and chronic disorders: An updated insight into prevalence, mechanisms and therapeutic modalities. Infection, Genetics and Evolution, 87, 104647. doi:10.1016/j.meegid.2020.104647
- Brooks, M. (2020). Post-COVID Wave Ahead of Death, Disability from Chronic Disease. https://www.medscape.com/viewarticle/948824
- Califf, R. (2021). Avoiding the Coming Tsunami of Common, Chronic Disease. Circulation, 143(19), 1831-1834. doi:10.1161/circulationaha.121.053461
- Cahan, E. (2021). Pandemic-Fueled Alcohol Abuse Creates Wave of Hospitalizations for Liver Disease. https://khn.org/news/article/pandemic-fueled-alcohol-abuse-creates-wave-of-hospitalizations-for-liver-disease/