Italian Doctors Offer Tips for Managing Celiac Disease and Gluten-Free Diet During the COVID-19 Pandemic

Celiac.com 12/28/2020 - With the outbreak of the SARS-CoV-2 virus, and cases of COVID-19 spreading worldwide, a number of people have been worried about celiac disease as a risk factor.  A team of clinicians recently compiled a list of guidelines to help gastroenterologists and nutritionists in supporting their celiac disease patients during the COVID-19 outbreak. 

Among their insights, the team reminds readers that there is currently no data on the risk of COVID-19 and its outcomes in celiac disease. But, there is no evidence that celiac disease in itself represents a COVID-19 risk factor. Proven risk factors for COVID-19 remain old age, hypertension, diabetes, coronary artery disease, pulmonary disease, chronic kidney disease, and high body mass index. 

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Depending on local recourses, the team encourages clinicians managing celiac patients during Covid-19 to initiate a rapid online service to address the patients’ doubts about a gluten-free diet, along with the use of POC tests for urinary gluten peptides and serological antibodies.

One potential impact of COVID-19 restrictions can be reduced access to gluten-free food, which celiacs require as treatment. The paper provides helpful advice on this, and numerous other topics, including: 

What about hyposplenism?
The team advise doctors to reassure patients that functional hyposplenism does not pose any greater risk for Covid-19.

Refractory celiac disease 
Patients with refractory celiac disease and/or taking immunosoppressive/chemotherapic agents could face a higher risk for COVID-19, and so they should be vigilant about social distancing and shielding.

Telecon clinics
Telemedicine and gastroenterological/nutritional video-consulting is very helpful to patients with celiac disease.

Dietary advice including Mediterranean and gluten-free dietary regimens
The paper offers helpful tips on improving patient diet, especially by following a gluten-free Mediterranean diet, and consuming more antioxidant micronutrients.

Read the full recommendations in BMC Gastroenterology volume 20, Article number: 387 (2020)

The clinicians team included Luca Elli, Donatella Barisani, Valentina Vaira, Maria Teresa Bardella, Matilde Topa, Maurizio Vecchi, Luisa Doneda, Alice Scricciolo, Vincenza Lombardo & Leda Roncoroni. They are variously affiliated with the Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; the Department of Pathophisiology and Transplantation, University of Milano, Milan, Italy; the School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; the Department of Pathophisiology and Transplantation, University of Milano, Milan, Italy; the Division of Pathology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; the Center for Prevention and Diagnosis of Celiac Disease, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy; and the Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.