No Higher Risk of Severe Covid-19, Hospitalization, or Death in Celiac Disease Patients

Celiac.com 02/23/2021 - People with celiac disease face a higher risk for developing pneumococcal pneumonia, and certain types of viral infections. Because of this, many people with celiac disease have wondered if they may have a higher risk of developing Covid-19, or of developing complications or severe Covid-19-related outcomes, if they do get it. The question was serious enough for a team of researchers to take a close look at the data to see whether people with celiac disease face an increased risk of hospitalization for Covid-19, intensive care unit admission, and/or death from Covid-19.

The research team included Benjamin Lebwohl, Emma Larsson, Jonas Söderling, Bjorn Roelstraete, Joseph A Murray, Peter HR Green, and Jonas F Ludvigsson. They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University Medical Center, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; the Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden;  the Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden;  the Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA; and the Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden.

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To get the answers they needed, the team put together a population-based group study from data gathered by 28 Swedish pathology departments from 1969-2017. They first identified nearly 41,000 patients with celiac disease, defined as small intestinal villus atrophy, who were still alive on February 1, 2020. 

They then compared data for these patients against data for nearly 184,000 controls matched by sex, age, county, and calendar period. 

Using Cox proportional hazards with follow-up through July 31, 2020, they first assessed risk of hospital admission with a primary diagnosis of laboratory-confirmed Covid-19. They then assessed risk of a Covid-19 admission to intensive care unit and/or death attributed to Covid-19.

They found that the overall risk of hospital admission for Covid-19 was 2.9 and 2.2 per 1000 person-years respectively. 

After adjusting for comorbidities, they found no significantly higher risk of hospitalization for Covid-19, or of severe Covid-19, among celiac patients.

Lastly, they saw no significant difference in mortality between celiac patients and control subjects who were hospitalized with Covid-19.

From this data, the team concludes that people with celiac disease are not at higher risk of hospitalization for Covid-19, or for Covid-19- related intensive care admission and/or death.

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