{
  "abstract": "Background\n\nChronic liver disease (CLD) and cirrhosis are major causes of mortality in the United States, with substantial variation by etiology, demographics, and geography. Alcohol-related liver disease (ALD) mortality increased before the COVID-19 pandemic and accelerated during its early phase. Whether alcohol-related and non-alcohol-related CLD and cirrhosis followed divergent mortality trajectories during and after the pandemic remains incompletely characterized.Methods\n\nWe conducted a population-based mortality study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) National Vital Statistics System data for deaths occurring from 2018 to 2024. Deaths were classified as ALD (K70) or CLD and cirrhosis not coded as alcohol-related (K73-K74). Periods were defined as pre-pandemic (2018-2019), pandemic (2020-2021), and post-acute pandemic (2022-2024). Outcomes included mortality counts, age-adjusted mortality rates, percentage changes, and years of potential life lost before age 75 (YPLL-75). All data aggregation, rate calculations, and statistical analyses, including confidence interval derivations, were performed using Python Version 3.10 (Python Software Foundation, Wilmington, Delaware, United States), utilizing the pandas and NumPy libraries. Analyses were stratified by sex, race and ethnicity, urbanization, and state.Results\n\nK70 deaths increased from 47,277 pre-pandemic to 62,601 during 2020-2021 (+32.4%), compared with an increase in K73-K74 deaths from 39,895 to 45,613 (+14.3%). During 2022-2024, K70 accounted for 87,294 deaths versus 71,982 for K73-K74. Average annual YPLL-75 increased by 38.8% for K70 compared with 19.5% for K73-K74, with YPLL per death consistently higher for K70. Marked disparities were observed by sex, race, urbanization, and state. American Indian or Alaska Native populations had the highest K70 mortality rates and largest pandemic-era increase, while nonmetropolitan populations experienced greater increases than metropolitan populations.Conclusions\n\nAlcohol-related and non-alcohol-related CLD and cirrhosis demonstrated distinct mortality trajectories during the pandemic era, with ALD contributing to a disproportionate burden of premature mortality. These findings describe temporal and etiologic differences in mortality and may inform targeted prevention and treatment strategies, although the observational design does not permit causal attribution to specific pandemic-related mechanisms.",
  "abstract_shown": true,
  "affiliations": [
    "General Practice, Ceda Orthopedic Group, Miami, USA.",
    "Clinical Research, Primary Care - Research Initiative (PCRI), Miami Lakes, USA.",
    "Primary Care, Hermes Medical Group, Miami, USA.",
    "Internal Medicine, Mount Sinai Medical Center, Hialeah, USA.",
    "General Practice, American Medical Association, Hialeah, USA.",
    "Urology, Mission City Urology, San Antonio, USA.",
    "Research and Development, Tricocenter Miami, Miami Lakes, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Elizabeth Blanco Espinosa"
    },
    {
      "affs": [
        1
      ],
      "name": "Yusvell Mori Gonzalez"
    },
    {
      "affs": [
        2
      ],
      "name": "Leandro Patterson"
    },
    {
      "affs": [
        1
      ],
      "name": "Javier A Mendoza"
    },
    {
      "affs": [
        3
      ],
      "name": "Wendy Larrondo Del Campo"
    },
    {
      "affs": [
        1
      ],
      "name": "Gabriela Sanchez"
    },
    {
      "affs": [
        1
      ],
      "name": "Francisco Sotolongo Castro"
    },
    {
      "affs": [
        4
      ],
      "name": "Yurisleydis Dominguez"
    },
    {
      "affs": [
        5
      ],
      "name": "Juan T Vargas Rivera"
    },
    {
      "affs": [
        1
      ],
      "name": "Aitor J Roche Perez"
    },
    {
      "affs": [
        1,
        6
      ],
      "name": "Carlos Acosta-Batista"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7d3eb769zygm3.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.116773",
  "fulltext_url": "https://europepmc.org/articles/PMC13693442",
  "id": "7d3eb769zygm3",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/MED/42921491",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2721|Liver Disease and Transplantation"
    ]
  ],
  "openalex": "W7214076208",
  "pdf_url": "https://europepmc.org/articles/PMC13693442?pdf=render",
  "pmcid": "PMC13693442",
  "pmid": "42921491",
  "published": "2026-09-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7d3eb769zygm3.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42921491",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42921491"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Liver Disease and Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Impact of the COVID-19 Pandemic on Chronic Liver Disease and Cirrhosis Mortality in the United States: A Divergent Trend Analysis by Underlying Etiology (2018-2024).",
  "title_text": "Impact of the COVID-19 Pandemic on Chronic Liver Disease and Cirrhosis Mortality in the United States: A Divergent Trend Analysis by Underlying Etiology (2018-2024).",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/7d3eb769zygm3",
  "venue": "Cureus",
  "versions": []
}