Study Explores the Link Between Covid-19 and Celiac Disease

Celiac.com 06/12/2023 - Celiac disease is an autoimmune disorder characterized by gastrointestinal symptoms and nutrient deficiencies. While genetic factors, particularly HLA association, play a significant role in its development, the exact environmental triggers remain unclear. 

Recent studies have proposed infections as potential contributing factors. With the Covid-19 pandemic causing a systemic inflammatory response and affecting the gastrointestinal tract, researchers in southern Sweden set out to investigate whether Covid-19 infection could increase the risk of developing celiac disease. 

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The research team included Jesper Lexner, Ylva Lindroth and Klas Sjöberg. They are variously affiliated with the Department of Gastroenterology and Nutrition, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden; and the Division of Medical Microbiology, Department of Laboratory Medicine, Skåne University Hospital, Lund University, Lund, Sweden.

The Covid-19 and Celiac Disease Connection

To explore the potential association between Covid-19 infection and celiac disease, the researchers identified all patients, including children and adults, in the county of Skåne with newly diagnosed biopsy- or serology-verified celiac disease or positive tissue transglutaminase antibody tests (tTG-ab) from 2016 to 2021. They also identified individuals who tested positive for Covid-19 using PCR or antigen tests in 2020 and 2021.

The Findings

During the period from March 2020 to December 2021, there were 201,050 cases of Covid-19 in Skåne, and among them, 568 patients were diagnosed with celiac disease or had positive tTG-ab tests. Interestingly, only 35 of these patients had previously been infected with Covid-19.

Contrary to initial expectations, the incidence of verified celiac disease and tTG-ab positivity was lower during the Covid-19 pandemic compared to before. The incidence rates of celiac disease were 21.1 and 22.4 cases per 100,000 person-years for patients with and without prior Covid-19 infection, respectively.

Implications of the Study

The findings of this study suggest that Covid-19 infection is not a significant risk factor for the development of celiac disease. While previous research has indicated that gastrointestinal infections may play a role in the pathogenesis of celiac disease, respiratory infections, such as those caused by the SARS-CoV-2 virus, appear to have less relevance in this regard.

Study Limitations

It is important to note that this study focused on a specific region in southern Sweden and the findings may not be generalizable to other populations or geographic areas. 

Further research involving larger and more diverse populations is warranted to validate these findings. Additionally, the study did not explore potential mechanisms underlying the connection between gastrointestinal infections and celiac disease pathogenesis, highlighting the need for future investigations in this area.

Understanding the environmental triggers and risk factors associated with celiac disease is crucial for improving diagnosis, treatment, and prevention strategies. While the Covid-19 pandemic has posed significant challenges worldwide, this study suggests that Covid-19 infection does not increase the risk of developing celiac disease. 

Read more in BMC Gastroenterology volume 23, Article number: 174 (2023)