Celiac Disease and COVID-19: Reassuring Data on Outcomes

Megan Brooks

December 02, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Adults with celiac disease (CD) do not appear to be at increased risk of having a more severe disease course or worse outcomes from COVID-19, according to a new study.

Patients with CD are a "population of interest" in terms of the clinical outcomes of COVID-19, say Emad Mansoor, MD, Digestive Health Institute, University Hospitals of Cleveland, Ohio, and colleagues.

There is emerging evidence that chronic disorders may have an impact on COVID-19 outcomes. But until now, the consequences of COVID-19 in patients with CD have been unclear.

The study was published online November 11 in Gut.

To investigate, Mansoor and colleagues used the TriNetX electronic health record database to identify 599 patients with CD and confirmed COVID-19 and 810,972 patients without CD but with confirmed COVID-19 from 51 healthcare organizations in the United States.

After propensity-score matching, the CD and non-CD cohorts were "relatively balanced"; there were 598 patients in each group.

Before propensity-score matching, COVID-19 patients with CD were significantly more likely to be hospitalized than peers without CD (18.2% vs 11.3%; odds ratio [OR], 1.74; 95% CI, 1.41 – 2.14; P < .0001).

After matching, however, this association became insignificant (OR, 0.96; 95% CI, 0.71 – 1.11; P = .0906).

Before matching, patients with CD were also more apt to develop blood clots (5.3% vs 2.1%; OR, 2.69; 95% CI, 1.88 – 3.83; P < .0001) but not after matching (OR, 0.938; 95% CI, 0.57 – 1.54; P = .800).

The same pattern was observed for the two other outcomes of interest: mortality and need for care in the intensive care unit.

Overall, there were no significant differences among any of the measured outcomes between CD and non-CD patients with COVID-19 after propensity-score matching, Mansoor and colleagues report.

"This is the largest study characterizing CD patients with COVID-19 to date to systematically investigate outcomes of CD patients with COVID-19," Mansoor and colleagues write.

They also say that their findings are in line with a recent population-based study from Sweden, which found no significant increase in risk for hospitalization, severe COVID-19, or increase in death between CD and non-CD patients with COVID-19.

"Although reassuring, this study is all about outcomes in individuals with diagnosed CD and the potential impact of COVID-19 in patients with undiagnosed CD remains unknown," the researchers caution.

The study had no specific funding. The authors have disclosed no relevant financial relationships.

Gut. Published online November 11, 2021. Full text

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