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Clin Gastroenterol Hepatol . Increased Risk of Hospitalization in Celiac Disease with COVID-19 Infection is Mitigated by Vaccination

tetano

Editor, Senior Moderator
Clin Gastroenterol Hepatol


. 2023 Feb 6;S1542-3565(23)00089-7.
doi: 10.1016/j.cgh.2023.01.029. Online ahead of print.
Increased Risk of Hospitalization in Celiac Disease with COVID-19 Infection is Mitigated by Vaccination


Andrew Ford[SUP] 1 [/SUP], Arjun Chatterjee[SUP] 1 [/SUP], Ruishen Lyu[SUP] 2 [/SUP], John McMichael[SUP] 2 [/SUP], Claire Jansson-Knodell[SUP] 3 [/SUP], Alberto Rubio-Tapia[SUP] 4 [/SUP]



Affiliations

Abstract

Introduction: We sought to describe clinical characteristics of celiac disease (CD) patients infected with coronavirus disease 2019 (COVID-19) and estimate hospitalization risk, intensive care unit (ICU) requirement, mortality, and thrombosis, and the impact of vaccination on these outcomes.
Methods: We performed a single-center, retrospective cohort study comparing biopsy-proven CD patients to a matched sample of non-CD (referent) patients diagnosed with COVID-19 between 03/2020 and 01/2022. Matching ensured 2 referent patients for every 1 CD patient by age, sex, ethnicity, and COVID-19 diagnosis date. We also adjusted for general and celiac-specific co-morbidity. The primary outcome was hospitalization. Secondary outcomes included ICU requirement, mortality, and thrombosis. We also compared these outcomes between vaccinated and unvaccinated individuals.
Results: We included 330 patients: 110 with CD (mean age 48 years-old, 83% female) and 220 matched referents. Hospitalization occurred in 27 (24%) CD patients and 25 (11%) referent patients (HR 2.10; 95% CI 1.21-3.65; p=0.007). Vaccination was associated with significantly decreased risk of hospitalization (HR 0.53; 95% CI 0.31-0.93; p=0.026). Four unvaccinated CD patients and 2 unvaccinated referent patients required ICU. No mortality occurred among CD patients while 2 referent patients died. No thrombosis occurred in either group.
Conclusions: CD patients with COVID-19 have a higher risk of hospitalization compared to non-CD referents. This risk is mitigated by vaccination in CD patients as it is in non-CD referents. ICU requirement occurred only in unvaccinated CD patients and no CD patient died. Vaccination against COVID-19 should be strongly recommended in patients with CD as it is for non-CD patients in the general population.

Keywords: COVID; coronavirus; enteropathy; immunization; pandemic; vaccine.
 
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