Background and Aims: Alcohol consumption increased during the coronavirus disease-2019 (COVID-19)
pandemic in 2020 in the U.S. We projected the effect of increased alcohol consumption on alcohol-related liver
disease (ALD) and mortality.
Approach and Results: We extended a previously validated microsimulation model that estimated the shortand long-term effect of increased drinking during the COVID-19 pandemic in individuals in the US born
between 1920-2012. We modeled short- and long-term outcomes of current drinking patterns during COVID19 (status quo) using survey data of changes in alcohol consumption in a nationally representative sample
between February and November 2020. We compared these outcomes with a counter-factual scenario wherein
no COVID-19 occurs and drinking patterns do not change.
One-year increase in alcohol consumption during the COVID-19 pandemic is estimated to result in 8,000 [95%
UI 7,500-8,600] additional ALD-related deaths, 18,700 [95% UI 17,600-19,900] cases of decompensated
cirrhosis, and 1,000 [95% UI 1,000-1,100] cases of HCC, and 8.9 million disability-adjusted life-years between
2020 and 2040. Between 2020 and 2023, alcohol consumption changes due to COVID-19 will lead to 100
[100-200] additional deaths and 2,800 [2,700-2,900] additional decompensated cirrhosis cases. A sustained
increase in alcohol consumption for more than 1 year could result in additional morbidity and mortality.
Conclusions: A short-term increase in alcohol consumption during the COVID-19 pandemic can substantially
increase long-term ALD-related morbidity and mortality. Our findings highlight the need for individuals and
policymakers to make informed decisions to mitigate the impact of high-risk alcohol drinking in the US.
