COVID-19 and Gluten-Related Disorders

Facts and resources for COVID-19 and celiac disease, non-celiac gluten sensitivity, allergies and food intolerances

Jennifer Iscol
December 2020

Society for the Study of Celiac Disease:

“To date, there have been no studies or reports suggesting patients with celiac disease are at increased risk of COViD-19 compared to patients without celiac disease. A small proportion of celiac disease patients with severe malnutrition and weight loss, the rare complication of Type 2 refractory celiac disease, on immunosuppressive medications or with other serious illnesses may be at increased risk and should consult with their physicians.” Read the full statement

University of Chicago Celiac Disease Center

“Celiac disease is not considered to be an immunocompromised state in individuals, and in itself is not known to be a risk factor for severe [COVID-19] disease.” Read the full statement

Society for the Study of Celiac Disease:

“…As the safety and efficacy data on Covid vaccination has emerged, there is no evidence to suggest that people with celiac disease would be more prone to an adverse effect of vaccination. Celiac disease is not considered an allergy, and by itself does not prompt additional precaution when proceeding with vaccination.

‘Patients with concerns about vaccination and their particular circumstance should speak with their health care provider. We will undergo Covid-19 vaccination as soon as it is offered to us, and we urge our patients to do so.” Read the full statement

Canadian Celiac Association:

“…[W]e have seen the devastating effects of COVID-19 in the Canadian and worldwide population, and therefore, mass vaccination is crucial to provide immunity against this virus. We recommend that people with celiac disease receive the COVID-19 vaccine approved according to their provincially determined prioritization schedules.

“Having a diagnosis of celiac disease should not affect the efficacy of the vaccine and should not be associated with any added adverse outcome from vaccination. It is important to clarify that celiac disease is not considered an allergy, and therefore, there is no anticipated need to take any additional precaution when proceeding with vaccination.” Read the full statement

Once again, celiac disease is an autoimmune disorder, not an allergy. For patients with allergies, Allergic Living has articles, links and FAQs on the safety of the Pfizer and Moderna vaccines, known as mRNA vaccines. Food Allergy Research & Education (FARE) has a primer on mRNA COVID vaccines.

Extremely rare allergic reactions to the Pfizer vaccine are currently a subject of study. Follow CDC and FDA announcements for the latest information.

Non-celiac gluten sensitivity is a type of food intolerance. It is neither an autoimmune condition nor an allergy, even though it is sometimes referred to as a “gluten allergy.” Many patients with celiac disease have additional food intolerances and sensitivities that cause digestive problems or other uncomfortable symptoms. These are not allergies and are not known to be associated with an adverse vaccine reaction.

The difference between food allergies and intolerances is explained in resources by the Mayo Clinic and Harvard Medical School.

Doctors are encouraged to register their patients who have celiac disease and are diagnosed with COVID-19. It takes about five minutes. The goal of this international registry founded by the Celiac Disease Center at Columbia University and Odense University Hospital in Denmark is to rapidly define the impact of COVID-19 on patients with celiac disease and how factors such as age, comorbidities, and treatments for celiac disease impact COVID outcomes.
Patient registry: SECURE-Celiac (Surveillance Epidemiology of Coronavirus Under Research Exclusion) https://covidceliac.org

MassGeneral Hospital for Children
FAQs, videos, a survey and more
https://www.massgeneral.org/children/celiac-disease/covid-19-and-celiac-disease

National Celiac Association
Facts, videos and links, including gluten-free food assistance information
https://nationalceliac.org/celiac-disease-and-covid-19/
Harvard Medical School Q&A on COVID-19 and Celiac Disease with Alessio Fasano, MD, and Jonathon Li, MD (September 2020)

Celiac Disease Center at Columbia University
An episode of The Celiac Project Podcast featured Peter H.R. Green, MD, director of the Celiac Disease Center (March 2020)

Celiac Disease Foundation
Facts, articles and resources
https://celiac.org/coronavirus-information/

University of Chicago Celiac Disease Center
Statement and links
https://www.cureceliacdisease.org/covid-19/

The risk of contracting COVID-19 is not increased in patients with celiac disease
Clin Gastroenterol Hepatol. 2020 Oct 12;S1542-3565(20)31398-7. DOI: https://doi.org/10.1016/j.cgh.2020.10.009. Online ahead of print.

Prevalence of COVID-19 in Italian children with celiac disease: a cross-sectional study
Lionetti E, Fabbrizi A, Catassi C, Prevalence of COVID-19 in Italian children with celiac disease: a cross-sectional study., Clinical Gastroenterology and Hepatology (2021), DOI: https://doi.org/10.1016/j.cgh.2020.11.035

How to manage celiac disease and gluten-free diet during the COVID-19 era: proposals from a tertiary referral center in a high-incidence scenario.
Elli L, Barisani D, Vaira V, Bardella MT, Topa M, Vecchi M, Doneda L, Scricciolo A, Lombardo V, Roncoroni L.
BMC Gastroenterol. 2020 Nov 19;20(1):387. DOI: https://doi.org/10.1186/s12876-020-01524-4

COVID-19 pandemic perception in adults with celiac disease: an impulse to implement the use of telemedicine
Monica Siniscalchi, Fabiana Zingone, Edoardo Vincenzo Savarino, Anna D’Odorico, Carolina Ciacci. Digestive and Liver Disease, Volume 52, Issue 10, October 2020, Pages 1071-1075 DOI: https://doi.org/10.1016/j.dld.2020.05.022

Centers for Disease Control and Prevention (CDC)
Recommendations for COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/index.html

Johns Hopkins
https://coronavirus.jhu.edu/data

World Health Organization
https://www.who.int/emergencies/diseases/novel-coronavirus-2019

Canada
https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html#faq

Mexico
https://coronavirus.gob.mx