Patients with celiac disease have twofold higher risk for COVID-19-related hospitalization
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Vaccination against COVID-19 is strongly recommended in patients with celiac disease, who are at greater risk for hospitalization due to SARS-CoV-2 infection compared with people who do not have celiac disease, according to research.
“While studies have shown increased susceptibility to viral illnesses, the research to date has demonstrated similar incidences and outcomes between those with celiac disease (CD) with COVID-19 and the general population,” Andrew Ford, MD, an internal medicine resident at Cleveland Clinic, and colleagues wrote in Clinical Gastroenterology and Hepatology. “Although the humoral response to SARS-CoV-2 vaccines was similar in CD to that observed in healthy controls, prior reports about outcomes of CD and COVID-19 were dated before the availability of COVID-19 vaccines.
“Therefore, the effect of vaccination on COVID-19 outcomes in patients with CD is unknown.”
In a retrospective cohort study, Ford and colleagues used electronic medical records to compare 110 patients with CD who tested positive for SARS-CoV-2 between March 2020 and January 2022 at Cleveland Clinic (mean age, 48 years; 83% women) and 220 reference patients without CD, also diagnosed with COVID-19.
The primary outcome of interest was hospitalization, while secondary outcomes included ICU requirement, mortality and thrombosis. Researchers also analyzed how vaccination status affected these outcomes.
According to results, 24% of patients were hospitalized in the CD group because of COVID-19 compared with 11% of patients in the reference group (HR = 2.1; 95% CI, 1.21-3.65), and vaccination was associated with a “significantly decreased risk” for hospitalization (HR = 0.53; 95% CI, 0.31-0.93). However, the need for hospitalization did not significantly differ between vaccinated patients with CD and without CD (OR = 1.12; 95% CI, 0.35-4).
Researchers reported four unvaccinated patients with CD required ICU care vs. two unvaccinated reference patients, and no incidence of thrombosis among either group. Further, there were no COVID-19-related deaths reported in the CD group compared with two — one vaccinated and one unvaccinated — in the reference group.
“This study demonstrated a higher risk of hospitalization among biopsy-proven CD patients with COVID-19 infection compared to those without CD,” Ford and colleagues concluded. “Additionally, our study shows a mitigation of the risk of hospitalization among CD patients vaccinated against COVID-19 similar to that seen in vaccinated non-CD patients.”
They continued: “Despite this increased risk of hospitalization, there were no significant differences between CD and non-CD patients with respect to ICU requirement, mortality or thrombosis. Vaccination against COVID-19 should be strongly recommended in patients with CD.”
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