The Risk of Contracting COVID-19 Is Not Increased in Patients With Celiac Disease

Zhen, Jamie; Stefanolo, Juan P.; Temprano, María de la Paz; Tedesco, Sebastian; Seiler, C; Caminero, Alberto; de-Madaria, Enriqué; Montoro, Miguel; Vivas, Santiago; Niveloni, Sonia I.; Berčík, Přemysl; Smecuol, Edgardo; Uscanga, Luis; Trucco, Elena; López, Virginia; Olano, Carolina; Mansueto, Pasquale; Carroccio, Antonio; Green, Peter H.R.; Day, Andrew S.; Tye–Din, Jason A.; Bai, Julio C.; Ciacci, Carolina; Verdú, Elena F.; Lebwohl, Benjamin; Pinto-Sanchez, M I

doi:10.1016/j.cgh.2020.10.009

Cited by 41 publications

(43 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Out of 387 children with CD recruited, 23 (5.9%) children reported COVID-19 like symptoms but none of them had a laboratory diagnosis of COVID-19 using a nasopharyngeal swab for real time RT-PCR. There were no complications reported in the supgroup of patients who experienced COVID-19 like symptoms and there was no significant increase in the prevalence of COVID-19 compared to the general population ( 101 , 102 ).…”

Section: Impact Of Covid-19 On Pediatric Gastroenterologymentioning

confidence: 76%

SARS-CoV-2 and the Gastrointestinal Tract in Children

et al. 2021

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19), caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is predominantly a respiratory disease. However, its significant impact on the gastrointestinal (GI) system is now well-known. SARS-CoV-2 enters cells via the angiotensin-converting enzyme-2 (ACE-2) receptor, which is abundantly expressed on lung cells, but also on enterocytes. Several etiopathogenetic mechanisms have been postulated to explain the GI involvement in COVID-19, including loss in intestinal absorption, microscopic mucosal inflammation and impaired ACE-2 function, which plays a significant role in maintaining gut homeostasis. In children the GI manifestations include anorexia, nausea, vomiting, diarrhea and abdominal pain, which may represent the earliest presenting symptoms of the disease. However, although rare, a significant GI mucosal inflammation, such as terminal ileitis mimicking an atypical appendicitis, and other GI manifestations have been reported. COVID-19 pandemic has posed a significant challenge in healthcare provision in term of ability in providing safe diagnostic procedures, face-to-face consultations, and offering comprehensive care. For instance, changes in health services have raised the risk of empirical or sub-optimal management of chronic GI disorders such as inflammatory bowel disease (IBD) due to delayed endoscopic and clinical assessment. This review will discuss the acute GI involvement in COVID-19 in children and reflect on challenges and major changes observed in clinical practice during COVID-19 pandemic by sharing both the published literature and personal experience. We also suggest potential strategies for providing optimal gastroenterology care during this unprecedented era.

show abstract

Section: Impact Of Covid-19 On Pediatric Gastroenterologymentioning

confidence: 76%

SARS-CoV-2 and the Gastrointestinal Tract in Children

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 21 A subsequent international survey of CeD patients based on self-reported CeD and Covid-19 diagnoses likewise found no increased risk of developing Covid-19 compared to controls. 22 An international registry for healthcare professionals, SECURE-Celiac ( www.covidceliac.org ), is tracking patients with CeD who develop Covid-19, so as to identify disease-specific risk factors for severe outcomes. The null results also suggest that the previously-described associations between CeD and cardiovascular disease 23 and diabetes 24 are not sufficiently strong so as to mediate an increased risk of Covid-19, even though they are established risk factors for severe outcomes in Covid-19; 25 when examining HR’s that do not adjust for these and other comorbidities, there remained no significant association between CeD and Covid-19 in our analysis.…”

Section: Discussionmentioning

confidence: 99%

Risk of Severe Covid-19 in Patients with Celiac Disease: A Population-Based Cohort Study

Lebwohl¹,

Larsson²,

Söderling³

et al. 2021

CLEP

Self Cite

View full text Add to dashboard Cite

Background Patients with celiac disease (CeD) are at increased risk of certain viral infections and of pneumococcal pneumonia, raising concerns that they may be susceptible to severe coronavirus disease 2019 (Covid-19). We aimed to quantify the association between CeD and severe outcomes related to Covid-19. Methods We performed a population-based cohort study, identifying individuals with CeD in Sweden, as defined by small intestinal villus atrophy diagnosed at all (n=28) Swedish pathology departments during the years spanning 1969–2017, and alive on February 1, 2020. We compared these patients to controls matched by sex, age, county, and calendar period. We performed Cox proportional hazards with follow-up through July 31, 2020, assessing risk of 1) hospital admission with a primary diagnosis of laboratory-confirmed Covid-19 (co-primary outcome); and 2) severe disease as defined by admission to intensive care unit and/or death attributed to Covid-19 (co-primary outcome). Results Among patients with CeD (n=40,963) and controls (n=183,892), the risk of hospital admission for Covid-19 was 2.9 and 2.2 per 1000 person-years respectively. After adjusting for comorbidities, the risk of hospitalization for Covid-19 was not significantly increased in patients with CeD (HR 1.10; 95% CI 0.80–1.50), nor was the risk of severe Covid-19 increased (HR 0.97; 95% CI 0.59–1.59). Results were similarly null when we compared CeD patients to their non-CeD siblings with regard to these outcomes. Among all patients with CeD and controls hospitalized with a diagnosis of Covid-19 (n=58 and n=202, respectively), there was no significant difference in mortality (HR for CeD compared to controls 0.96; 95% CI 0.46–2.02). Conclusion In this population-based study, CeD was not associated with an increased risk of hospitalization for Covid-19 or intensive care unit and/or death attributed to Covid-19.

show abstract

“…Numerous studies suggest that CeD is associated with an increased risk of respiratory infections, particularly pneumonia, tuberculosis, and influenza[ 4 - 6 ]. However, we have shown that the odds of contracting COVID-19 in patients with CeD is similar to that of the general population[ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Risk perception and knowledge of COVID-19 in patients with celiac disease

Zhen¹,

Stefanolo²,

Temprano³

et al. 2021

WJG

Self Cite

View full text Add to dashboard Cite

BACKGROUND We recently demonstrated that the odds of contracting coronavirus disease 2019 (COVID-19) in patients with celiac disease (CeD) is similar to that of the general population. However, how patients with CeD perceive their COVID-19 risk may differ from their actual risk. AIM To investigate risk perceptions of contracting COVID-19 in patients with CeD and determine the factors that may influence their perception. METHODS We distributed a survey throughout 10 countries between March and June 2020 and collected data on demographics, diet, COVID-19 testing, and risk perceptions of COVID-19 in patients with CeD. Participants were recruited through various celiac associations, clinic visits, and social media. Risk perception was assessed by asking individuals whether they believe patients with CeD are at an increased risk of contracting COVID-19 when compared to the general population. Logistic regression was used to determine the influencing factors associated with COVID-19 risk perception, such as age, sex, adherence to a gluten-free diet (GFD), and comorbidities such as cardiac conditions, respiratory conditions, and diabetes. Data was presented as adjusted odds ratios (aORs) RESULTS A total of 10737 participants with CeD completed the survey. From them, 6019 (56.1%) patients with CeD perceived they were at a higher risk or were unsure if they were at a higher risk of contracting COVID-19 compared to the non-CeD population. A greater proportion of patients with CeD perceived an increased risk of contracting COVID-19 when compared to infections in general due to their CeD (56.1% vs 26.7%, P < 0.0001). Consequently, 34.8% reported taking extra COVID-19 precautions as a result of their CeD. Members of celiac associations were less likely to perceive an increased risk of COVID-19 when compared to non-members (49.5% vs 57.4%, P < 0.0001). Older age (aOR: 0.99; 95%CI: 0.99 to 0.99, P < 0.001), male sex (aOR: 0.84; 95%CI: 0.76 to 0.93, P = 0.001), and strict adherence to a GFD (aOR: 0.89; 95%CI: 0.82 to 0.96, P = 0.007) were associated with a lower perception of COVID-19 risk and the presence of comorbidities was associated with a higher perception of COVID-19 risk (aOR: 1.38; 95%CI: 1.22 to 1.54, P < 0.001). CONCLUSION Overall, high levels of risk perceptions, such as those found in patients with CeD, may increase an individual’s pandemic-related stress and contribute to negative mental health consequences. Therefore, it is encouraged that public health officials maintain consistent communication with the public and healthcare providers with the celiac community. Future studies specifically evaluating mental health in CeD could help determine the consequences of increased...

show abstract

The Risk of Contracting COVID-19 Is Not Increased in Patients With Celiac Disease

Cited by 41 publications

References 9 publications

SARS-CoV-2 and the Gastrointestinal Tract in Children

SARS-CoV-2 and the Gastrointestinal Tract in Children

Risk of Severe Covid-19 in Patients with Celiac Disease: A Population-Based Cohort Study

Risk perception and knowledge of COVID-19 in patients with celiac disease

Contact Info

Product

Resources

About