As international headlines surround the COVID-19 pandemic, those with celiac disease may have concerns about what the condition means for them and their dietary treatments.
Currently, there is no research to indicate if those with celiac disease are at higher risk for developing COVID-19 or its complications. However, people in the celiac disease community should consider specific factors.
Read on to learn more about how COVID-19 can affect people with celiac disease.
Stay informed with live updates on the current COVID-19 outbreak and visit our coronavirus hub for more advice on prevention and treatment.
Celiac disease is an autoimmune disorder resulting from the inability to tolerate gluten, a protein found in or added to many foods.
The condition can cause inflammation in the body, which can lead to symptoms such as chronic fatigue, joint pain, iron-deficiency anemia, and more.
COVID-19 is a highly contagious disease that can cause severe and fatal acute respiratory symptoms.
While researchers are still gathering data about the condition, they know that people with high-risk medical conditions are at higher risk for developing COVID-19 symptoms and experiencing worse complications.
According to best practice guidelines from the British Medical Journal (BMJ), strong risk factors for COVID-19 include:
- chronic respiratory disease
- diabetes
- hypertension
- immunocompromised
- severe obesity
Often, the term “immunocompromised” can cause people with celiac disease to wonder if they fall into this category and whether they should be more concerned about their risks for COVID-19.
While celiac disease is an immune-related response, doctors do not consider those with celiac disease to be immunocompromised, according to the National Celiac Association (NCA).
However, the NCA also state that those with celiac disease (especially active celiac disease, where a person experiences routine celiac disease symptoms) are more susceptible to infections.
Specifically, the Celiac Disease Center at Columbia University Medical Center report increased risks for worse outcomes with influenza infection. and increased risks for pneumonia infections related to pneumococcal bacteria when a person has celiac disease.
However, the Center caution that these risks are often only slightly increased compared to the general population and only identified in small studies.
Doctors do not yet know if the same increases in worsening outcomes would be true for those with celiac disease and COVID-19.
More information about COVID-19 became available in
Since that time, information has been rapidly evolving. However, doctors still do not have the full clinical picture as to how the novel coronavirus affects specific populations.
However, several larger organizations supporting and advising people with celiac disease have included information about COVID-19 and celiac disease on their websites. These statements include:
- National Celiac Association: The Association reports “no evidence to suggest that someone with well-controlled celiac disease would be more vulnerable” to COVID-19 than when compared to those who do not have celiac disease.
- Celiac Disease Center at Columbia University Medical Center: The Center currently reports there is “no data” concerning COVID-19 and celiac disease.
The Center does acknowledge the likelihood of a reasonable connection between slightly worse outcomes from COVID-19 in those with celiac disease.
Their researchers have created an international registry where people who have celiac disease and have tested positive for COVID-19 can report. The Center’s staff can then track any connections and outcomes between COVID-19 and celiac disease.
- Dr. Alessio Fasano from Massachusetts General Hospital: In a March 2020 video on the Massachusetts General Hospital YouTube channel, Dr. Fasano addressed concerns regarding celiac disease and COVID-19.
Dr. Fasano states that those with celiac disease are “not immunocompromised patients,” but if they have active celiac disease, they may be more susceptible to .
Most celiac disease-related organizations encourage those with celiac disease to maintain control over their condition and watch for information from major health organizations for more information about COVID-19.
Those with COVID-19 report a wide range of symptoms.
According to the
- dry cough
- fever
- severe shortness of breath
These symptoms may appear
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- fatigue
- muscle aches
- sore throat
- runny nose
- nausea
Some people report diarrhea and other digestive issues. However, these may be hard to recognize as specific to COVID-19 because people with celiac disease may regularly experience these symptoms.
Other people also report a lack of smell and taste, which is known as anosmia. Health experts have not yet adopted anosmia as an official criterium for diagnosis. However, ENT UK have recommended it as a symptom, and a preliminary study from King’s College London in the United Kingdom suggests it may be a key symptom.
A person with celiac disease often follows a careful, gluten-free diet to manage their condition.
This may present challenges as shelter-at-home orders limit trips to the grocery store, and many restaurants have closed their doors or offer takeout only options.
Whenever possible, a person should try to buy about a week’s worth of gluten-free foods. Examples of options with an extended shelf life include:
- beans
- chia
- flax
- frozen, gluten-free bread
- oats, including those in gluten-free labeled granola bars
- rice
A person may also wish to purchase frozen gluten-free vegetables and fruits. People who are in quarantine can store these foods for an extended period.
In addition to these considerations for maintaining a gluten-free diet, a person with celiac disease should follow the same recommendations as other individuals when it comes to preventing COVID-19 transmission.
This includes staying at home whenever possible, limiting close contact with others, washing hands frequently, and avoiding touching their face.
Currently, there is no cure for COVID-19. Researchers around the world are experimenting with a range of treatments, including antimalarials, antivirals, antibiotics, and many more.
People with mild symptoms may be able to treat COVID-19 at home. Steps include:
- drinking plenty of fluids to avoid dehydration
- taking over-the-counter fever reducers, such as ibuprofen or acetaminophen
- getting plenty of rest
Some people will require hospitalization to receive extra oxygen or even require intubation and support from a ventilator. As of March 2020, these treatments are only necessary in a small percentage of severe COVID-19 cases.
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If a person with celiac disease does require hospitalization and can eat, they must notify the hospital that they have celiac disease and need a gluten-free diet.
The Americans with Disabilities Act requires hospitals to provide gluten-free foods. However, hospitals may have limited food options, given food shortages and transportation concerns due to COVID-19.
However, many hospitals offer gluten-free foods as a standard part of their menu. These include:
- baked potatoes
- most pre-packaged meal supplements, such as Boost or Ensure (make sure the label states ‘gluten-free’)
- plain, hard-boiled eggs
- plain protein sources, such as chicken, fish, or red meat
- plain rice
- vegetables
- yogurt
Choosing these foods at the hospital while a person is recovering from COVID-19 can help a person manage their celiac disease.
Doctors and researchers are continually gathering data about COVID-19, including its incidence and recovery.
As more information becomes available, researchers may be able to identify if there are links between the COVID-19 and celiac disease, especially when it comes to mortality and disease severity.
Researchers are collecting information about the incidence of COVID-19 in people with certain medical conditions, including celiac disease.
Maintaining control and preventing active celiac disease, as well as taking preventive measures against COVID-19, can be a person’s best chance to maintain their overall health.
Anyone with celiac disease that thinks that they may have developed COVID-19 should call their doctor or hospital before going in-person. Their medical facility can direct them as to which steps to take to receive a diagnosis and treatment.
For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.