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Alcohol Use Disorder Contributes to Higher Death Rates During Pandemic

Alcohol use disorder appears to have played an outsized role in higher mortality rates in the United States during the COVID-19. Find out how much deaths from AUD itself increased during the time period and also why misuse of alcohol raises the risk of having a severe case of SARS-CoV-2 infection.

LOS ANGELES – Alcohol use disorder and related deaths appear to have been a driver in the increase in mortality rates in the United States during the COVID-19 pandemic, especially among younger people.

A new study in JAMA Network Open points out, “Mounting evidence indicates that alcohol sales, alcohol consumption, and complications of alcohol use have increased during the pandemic.”

Cedars-Sinai Medical Center-led authors note, however, that limited data exist on AUD–related mortality. To remedy that, the study team used projective modeling to evaluate AUD-related mortality rates in the United States from 2012 to 2021, focusing on trends during the COVID-19 pandemic.

Researchers quantified the association of the pandemic with AUD-related deaths by calculating percentage differences between the projected and observed mortality rates. They also performed a sensitivity analysis by setting AUD as the underlying (primary) cause of death.

Results indicate that 343,384 AUD-related deaths occurred between 2012 and 2021. Stratified by age, that is: 25 to 44 years, 56,985 [16.6%]; 45 to 64 years, 192,346 [56.0%]; and 65 years, 94 053 [27.4%].

The large majority, 77.7%, occurred in men, 266,755.

“By comparing observed and projected mortality rates, we noticed a surge in AUD mortality both overall and among all subgroups during the pandemic.” the authors advise. “The observed AUD-related mortality rates increased by 24.79% in 2020 and 21.95% in 2021 vs. the projected rates.”

The study explains that increased mortality rates were clear even when AUD was set as the primary cause of death -- 30.74% in 2020 vs 28.77% in 2021.

“In this study, the youngest age group (25-44 years) demonstrated the largest increase in AUD mortality (40.47% in 2020 vs 33.95% in 2021) across all age groups,” according to the report. “The increase was similar for both sexes (approximately 24.65% for women and men in 2020 vs 20.08% and 22.41% in 2021.”

That the study looked at AUD as a primary cause of death is significant, but a study from the Department of Veterans Affairs Omaha-Western Iowa Health Care System, earlier this year found the condition was associated with more severe cases of COVID-19.

“Alcohol misuse is long established as a contributor to the pathophysiology of the lung,” according to the article in the journal Alcohol. “The intersection of multi-organ responses to alcohol-mediated tissue injury likely contributes to the modulation of lung in response to injury. Indeed, the negative impact of alcohol on susceptibility to infection and on lung barrier function is now well documented. Thus, the alcohol lung represents a very likely comorbidity for the negative consequences of both COVID-19 susceptibility and severity.”