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Those with celiac disease not at increased risk of getting COVID-19

October 14, 2020

New study find odds are the same as the general public

By Amy Ratner, Medical and Science News Analyst

A survey of more than 10,000 people with celiac disease around the world found the risk of getting COVID-19 was not increased compared to the general population.

“Patients with celiac disease have similar odds of contracting COVID-19 and may not need to take additional precautions to prevent exposure aside from that recommended to the general public,” the study by researchers from nine countries, including the United States, concluded.

While celiac disease experts early in the pandemic had said those with celiac disease most likely faced risks similar to the general public, the research now provides evidence, according study author Maria Ines Pinto-Sanchez, MD, associate professor of medicine at McMaster University.

“We are encouraged by the findings of this study which provide a large set of data supporting our views, as well as those of several experts in the field, that celiac disease patients have no higher risk of contracting COVID-19,” said Salvo Alesci, MD, Beyond Celiac chief scientist and strategy officer. He noted that the study results are consistent with  internal research by Beyond Celiac using a similar survey format and the Go Beyond Celiac database. “As new data become available, it will be important to continue evalutating them to see if they confirm these observations, as well as adding new information on differences in duration, severity or treatment response in the celiac disease compare to  general patient populations,” he said. 

First large study

“To our knowledge, this is the first large-scale study to examine the risk of COVID-19 in celiac disease compared to the non-celiac disease population,” study authors wrote. “We found patients with celiac disease had similar odds of contracting COVID-19 when compared with controls.”

The 18,000 study participants, which included 7,500 who do not have celiac disease, filled out a 41-question online survey between March and June asking about COVID-19 exposure, testing and diagnosis. Physicians, researchers and celiac disease advocacy groups, including Beyond Celiac, collaborated to distribute the survey in the United States, Canada, Argentina, Spain, Mexico City, Uruguay, Italy, New Zealand, and Australia.

Those with celiac disease were less likely than those without the condition to have been tested for COVID-19, about 5 percent compared to about 7 percent, and less likely to have been exposed to the virus, about 2 percent compared to 4 percent, according to the study, published in the journal Clinical Gastroenterology and Hepatology.

Positive COVID-19 tests

Of 940 study participants who had been tested for COVID-19, about 9 percent reported positive results, and those with celiac disease and without were just as likely to have a positive test.

Those with celiac disease included 67 percent who followed a strict gluten-free diet and 32 percent who had persistent celiac disease symptoms. About 4 percent of participants who do not have celiac disease also reported following the gluten-free diet. Study participants with celiac disease more frequently reported other health conditions, including diabetes, and respiratory and cardiac diseases.

Related: What you need to know about celiac disease and COVID-19

“The presence of comorbidities, which was identified as important predictors of morbidity and mortality associated with COVID-19, were more frequent in celiac disease than controls,” study authors wrote. “However, this did not result in higher odds of a positive COVID-19 test in celiac disease.”

Safety precautions

Researchers had hypothesized that adopting a strict gluten-free diet and having fewer symptoms of celiac disease would decrease the odds of getting COVID-19, but that did not turn out to be the case.

Although nearly 30 percent of those with celiac disease report taking extra safety precautions for COVID-19 that did not change the likelihood of a positive test result. “Exposure to a COVID-19 contact was the only factor increasing the odds of a positive test,” the study says.

The study was limited by the fact that information was provided by participants in the online survey and could not be confirmed.

Severity of COVID-19 needs future study

Researchers noted that the study was not designed to assess differences in the severity of COVID-19 in celiac disease patients compared to controls.

“It is our hope that the ongoing international SECURE-Celiac registry will address this issue in the future,” they wrote.  As of October 1, the registry listed 73 cases of COVID-19 in celiac disease patients, 26 of which were in the United States. Of the 73, 12 required hospitalization, one in an intensive care unit, and one died.

The SECURE registry is restricted to healthcare providers taking care of patients with celiac disease and a documented case of COVID-19.  The registry was set up and is being managed by researchers from the Celiac Center at Columbia University and Odense University Hospital, Odense, Denmark.

You can read more about the study here.



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