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World J Hepatol. Oct 27, 2022; 14(10): 1875-1883
Published online Oct 27, 2022. doi: 10.4254/wjh.v14.i10.1875
Alcohol use disorder and liver injury related to the COVID-19 pandemic
Giuseppe Marano, Gianandrea Traversi, Eleonora Gaetani, Roberto Pola, Angelo Emilio Claro, Marianna Mazza
Giuseppe Marano, Angelo Emilio Claro, Marianna Mazza, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
Gianandrea Traversi, Dipartimento di Medicina di Laboratorio, UOSD Genetica Medica, Ospedale Generale “San Giovanni Calibita” Fatebenefratelli, Rome 00186, Italy
Eleonora Gaetani, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
Roberto Pola, Division of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
Author contributions: Mazza M and Marano G designed the study and wrote the first draft of the manuscript; Traversi G, Gaetani E, Pola R, and Claro AE supervised and added important contributions to the paper; All authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marianna Mazza, MD, PhD, Assistant Professor, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, Rome 00168, Italy. mariannamazza@hotmail.com
Received: August 21, 2022
Peer-review started: August 21, 2022
First decision: September 8, 2022
Revised: September 26, 2022
Accepted: October 10, 2022
Article in press: October 10, 2022
Published online: October 27, 2022
Processing time: 66 Days and 6.7 Hours
Abstract

Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components. Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte. The liver is the central organ in the metabolism of alcohol, a process that also involves other organs and tissues such as the brain, heart and muscles, but the most relevant organ is the liver. The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes, to cirrhosis and hepatocellular carcinoma. Alcohol abuse frequently leads to liver disease such as steatosis, steatohepatitis, fibrosis, cirrhosis, and tumors. Following the spread of coronavirus disease 2019 (COVID-19), there was an increase in alcohol consumption, probably linked to the months of lockdown and smart working. It is known that social isolation leads to a considerable increase in stress, and it is also recognized that high levels of stress can result in an increase in alcohol intake. Cirrhotic patients or subjects with liver cancer are immunocompromised, so they may be more exposed to COVID-19 infection with a worse prognosis. This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

Keywords: Alcohol use disorder; Alcoholic liver disease; Liver injury; COVID-19; Alcohol abuse; Alcohol dependence

Core Tip: Alcohol use disorder is a complex phenomenon with psychological and physical consequences. Alcohol-associated liver disease is a devastating complication of alcohol use disorder. Following the spread of coronavirus disease 2019 (COVID-19) and consequent lockdown there was an increase in alcohol consumption resulting in a worrying increase in steatosis of the liver, alcohol-related steato-hepatitis and alcohol-related liver disease. In addition, patients with alcohol-associated liver disease may be more susceptible to COVID-19 and a worse prognosis. This review focuses on the emergence of alcohol-induced liver damage as a major medical and social problem during the COVID-19 pandemic.