Coronavirus more susceptible to celiacs?

[Jewel Pancake]

I read that if you have an autoimmune disorder you’re more likely to get this. I was around a lot of people been in and out the er for the past few months my immune system is weak. Because of a vitamin deficiency. I’m really nervous about this not sure if it’s true or not, has anyone else heard this?

[cyclinglady]

Maybe.  Untreated celiacs can be more susceptible to any illness and that probably includes COVID-19.  

Your best bet is remain strictly gluten free.  If you are a newbie, concentrate on non-processed foods if possible.  Look for certified gluten-free products until you master the diet (and it has a steep learning curve).  Do not eat out unless it is a dedicated 100% gluten-free restaurant.  This can be relaxed once you are well and again, have mastered the diet.  Try to get some Vitamin D in your foods (e.g. fatty fish) and some sun when it is warm enough to expose your body a bit (hard to do in winter, I know).  

Follow the CDC recommendations (like washing your hands and social distancing).  ?

[Scott Adams]

I'm not sure if you saw this thread, but it might be helpful:

 

[GFinDC]

Dr. Alessio Fasano did a video about covid -19 and celiac.

 

 

[Awol cast iron stomach]

1 hour ago, GFinDC said:

Dr. Alessio Fasano did a video about covid -19 and celiac.

 

 

Thank you gluten-free in DC this is helpful.

[cristiana]

This is a great video - thank you.  I have to say I feel deeply uneasy in crowded places, so I'm hoping that the UK government will act soon to stop mass gatherings and all those who don't need to commute will stay at home, to help those who still need travel.

 

 

 

[cyclinglady]

On 3/13/2020 at 3:08 PM, Scott Adams said:

I'm not sure if you saw this thread, but it might be helpful:

 

Your link was about bacterial-related pneumonia and celiac disease and not viral pneumonia.  These studies encourage vaccination for bacterial pneumonia.   There is no vaccination for the COVID-19 virus.  Also, the COVID-19 virus presents very differently in the lungs.  This is not comparing apples to apples.  Let’s not spread fear.  

[cyclinglady]

2 hours ago, Awol cast iron stomach said:

Thank you gluten-free in DC this is helpful.

 

Great video!  Nice to hear about COVID-19 from a celiac disease specialist (medical doctor/GI).  Thank you for sharing.  It supports what I said earlier in the thread.  ?

[Scott Adams]

46 minutes ago, cyclinglady said:

Your link was about bacterial-related pneumonia and celiac disease and not viral pneumonia.  These studies encourage vaccination for bacterial pneumonia.   There is no vaccination for the COVID-19 virus.  Also, the COVID-19 virus presents very differently in the lungs.  This is not comparing apples to apples.  Let’s not spread fear.  

??? 

Nobody is trying to "spread fear" here. We are having a discussion about how celiacs might respond to this virus. Anyone at higher risk for pneumonia could have worse outcomes with this virus. This article makes it clear, and no differentiation is made between viral or bacterial, those at higher risk for pneumonia could have worse outcomes:

https://www.theguardian.com/world/2020/mar/13/coronavirus-what-happens-to-peoples-lungs-when-they-get-covid-19

Quote

Jenkins says that, generally, people aged 65 and over are at risk of getting pneumonia, as well as people with medical conditions such as diabetes, cancer or a chronic disease affecting the lungs, heart, kidney or liver, smokers, Indigenous Australians, and infants aged 12 months and under.

“Age is the major predictor of risk of death from pneumonia. Pneumonia is always serious for an older person and in fact it used to be one of the main causes of death in the elderly. Now we have very good treatments for pneumonia.

“It’s important to remember that no matter how healthy and active you are, your risk for getting pneumonia increases with age. This is because our immune system naturally weakens with age, making it harder for our bodies to fight off infections and diseases.”

 

[cyclinglady]

1 hour ago, Scott Adams said:

??? 

Nobody is trying to "spread fear" here. We are having a discussion about how celiacs might respond to this virus. Anyone at higher risk for pneumonia could have worse outcomes with this virus. This article makes it clear, and no differentiation is made between viral or bacterial, those at higher risk for pneumonia could have worse outcomes:

https://www.theguardian.com/world/2020/mar/13/coronavirus-what-happens-to-peoples-lungs-when-they-get-covid-19

 

I am older, so I am at more risk, but not because I have celiac disease.  My celiac disease is in remission.  Undiagnosed celiac disease patients can have a higher risk for bacterial pneumonia, just as they can for osteoporosis, cancer, anemia or other illnesses.  

Your previous links:

“People with celiac disease showed a much higher risk of bacterial pneumonia before celiac diagnosis.”

“Unvaccinated celiac patients under the age of 65 have an excess risk of community-acquired pneumonia that was not seen in vaccinated celiac patients.”

(would that hold true for anyone?  Just drop the word celiac.)

Just because you have celiac disease, you are not at higher risk for developing COVID-19 viral pneumonia, at least nothing that has been published since the inception of this virus.  Dr. Fasano has backed this up.  Your Guardian link mentions nothing about celiac disease or autoimmune diseases and their potential association or impact with COVID-19.

How were your links helpful?  Were you trying to calm Jewel Pancake and encourage her to get a bacterial pneumonia vaccination?  If so, I completely missed that.  We honestly do not even know if she has celiac disease or is an undiagnosed celiac.    She should really contact her doctor as we know nothing about her and her health history.  She should also follow government guidelines to prevent contracting COVID-19 as we all should.  

Stay safe.  ?

 

[Jewel Pancake]

I had bacteria pneumonia last month in my left lung I’m a young woman in her 20s so I need to be more careful I’m still short of breathe till this day ?

On 3/13/2020 at 12:47 AM, cyclinglady said:

Maybe.  Untreated celiacs can be more susceptible to any illness and that probably includes COVID-19.  

Your best bet is remain strictly gluten free.  If you are a newbie, concentrate on non-processed foods if possible.  Look for certified gluten-free products until you master the diet (and it has a steep learning curve).  Do not eat out unless it is a dedicated 100% gluten-free restaurant.  This can be relaxed once you are well and again, have mastered the diet.  Try to get some Vitamin D in your foods (e.g. fatty fish) and some sun when it is warm enough to expose your body a bit (hard to do in winter, I know).  

Follow the CDC recommendations (like washing your hands and social distancing).  ?

Yeah my vitamin d levels are at 5 so I definitely need more sun, thanks for the reply 

[GFinDC]

1 hour ago, Jewel Pancake said:

I had bacteria pneumonia last month in my left lung I’m a young woman in her 20s so I need to be more careful I’m still short of breathe till this day ?

Yeah my vitamin d levels are at 5 so I definitely need more sun, thanks for the reply 

Hi  Jewel Pancake,

That is a really low vitamin D level.  I know when I had low vitamin D I had sore joints and other symptoms from it.  You don't need to depend on the sun though.  You can take some Nature Made brand vitamin D pills daily and it should help.  Try to take it every day as the body needs time to build levels.  I take 1000 IU daily but they have larger doses too,

Another option is to eat oily fish like salmon, tuna, mackeral, and sardines.  They all have a good amount of vitamin D in them,

You might need calcium and boron too.  They both work together with vitamin D to maintain bone.

[Scott Adams]

On 3/14/2020 at 6:20 PM, cyclinglady said:

How were your links helpful?  Were you trying to calm Jewel Pancake and encourage her to get a bacterial pneumonia vaccination?  If so, I completely missed that.  We honestly do not even know if she has celiac disease or is an undiagnosed celiac.    She should really contact her doctor as we know nothing about her and her health history.  She should also follow government guidelines to prevent contracting COVID-19 as we all should.  

Stay safe.  ?

 

So the research on diabetics having an increased risk of pneumonia is nearly identical to the research links I posted about the increased risk of pneumonia in celiac disease. The research for diabetes showing this higher risk also references bacterial pneumonia and not viral pneumonia. So if the research on diabetes indicates that diabetics are at higher risk of bacterial pneumonia (just like celiacs are), then why are doctors around the world indicating that those with diabetes are at higher risk of pneumonia if they get COVID-19? The reason why is because any serious virus can increase your risk of all types of pneumonia, and certainly this is why those with certain autoimmune diseases like diabetes are at higher risk for it than the healthy population.

Why don't doctors mention celiac disease? Look at the dates of the articles I shared, all this research was done in the last 5-6 years, unlike the research on diabetes which was done decades ago. 

Naturally fully healed celiacs would have less to worry about than undiagnosed or newly diagnosed celiacs, however, the risk of pneumonia in celiac disease carries on longer, and is "maintained for more than 5 years after diagnosis," and it isn't clear that it ever goes away. Many people who visit this forum are in the category of being within 5 years of their diagnosis, and they probably don't know that they should have a pneumococcal vaccine, even if they are younger.  Thus I am sharing those links because they could be very helpful. 

I cannot say why Fasano doesn't recommend pneumococcal vaccine for celiacs in his video, but that is the current recommendation:

Quote

Interestingly, this increased risk was limited to those younger than 65, was highest around the time of diagnosis and was maintained for more than 5 years after diagnosis. Only 26.6% underwent vaccination after their celiac disease diagnosis.

Unvaccinated celiac patients under the age of 65 have an excess risk of community-acquired pneumonia that was not seen in vaccinated celiac patients. More patients with celiac disease need to be vaccinated to protect them from pneumonia.

I actually think statements like "Let's not spread fear" and "How were your links helpful?" are not helpful statements here, and aim only to shut down this discussion. 

Certainly the links I shared are relevant to many in the celiac disease community, especially in this age of COVID-19.

[Scott Adams]

PS - I am already talking to my doctor to get this vaccine...which I haven't done yet, but am now very motivated to do!

[cristiana]

I wonder what to make of this? (follow the link and it takes you to vaccinations) 

https://www.coeliac.org.uk/about-us/media-centre/news/coeliac-disease-and-coronavirus-update/

For the first time this year I was offered the pneumoccal vaccine, alongside my flu vaccine by my National Health Service nurse on the grounds I was a coeliac.  I didn't even know the vaccine existed.  I haven't had the other one they recommend - again, I didn't know it existed?  

What will be interesting is hopefully, because the Italians are so good at diagnosing coeliac disease in their population, we'll get some more up to date information soon.  I did find Fasano's words reassuring.

[Scott Adams]

If it makes you feel better the UK appears to be light years ahead of the USA in correctly following up on the recommendations to treat celiacs. As far as I know nobody here is recommending this vaccine for celiacs yet, even though the research supports it.

[Scott Adams]

I just wanted to share this post I just received from an email group I'm in. It's from Benjamin Lebwohl, MD, MS, Director of Clinical Research, The Celiac Disease Center at Columbia University. They are setting up a group to study whether those with celiac disease may have worse outcomes with COVID-19 than those without CD, and he does mention our increased risk for pneumococcal pneumonia as one reason that this needs to be studied further:

Quote

We have been asked by our patients about whether celiac disease is an “underlying condition” that may predispose to more severe outcomes. There have been some helpful responses by celiac organizations with an overall reassuring tone. Still, there are theoretical concerns related to the fact that patients with celiac disease have a slightly higher risk of developing zoster and complications from influenza and pneumococcal pneumonia, risks that persist in the long term after adoption of the gluten-free diet.  Thankfully, these  increases are small in magnitude, far smaller than risk factors such as immunosuppressant use or chronic lung disease.

In the face of uncertainty, we should be studying this. Our group is working to set up an international, web-based registry of celiac disease patients with Covid-19. We will be inviting health care professionals to submit clinical details in a concise and easy-to-input way. The registry will contain only de-identified data.

 

[Fenrir]

19 minutes ago, Scott Adams said:

I just wanted to share this post I just received from an email group I'm in. It's from Benjamin Lebwohl, MD, MS, Director of Clinical Research, The Celiac Disease Center at Columbia University. They are setting up a group to study whether those with celiac disease may have worse outcomes with COVID-19 than those without celiac disease, and he does mention our increased risk for pneumococcal pneumonia as one reason that this needs to be studied further:

 

This would indicate that not enough is really known about the subject to assume anything and the if there is an increased risk it's small one compared others. 

It's probably good they're setting up a registry, maybe we'll find out if we're susceptible or not. Based on current info it's "probably not" but don't know for sure. 

Also, the use of "theoretical" indicates that there's some effort to connect dots. Just because something applies to A or B doesn't mean that it applies to C unless we have better info. Certainly could be that we find out it's an issue but really right now we don't really know. I don't think we have data on how celiacs faired VS H1N1 but that would probably be a better comparison to Covid-19. 

I think the bigger thing with this virus, if it ends up infecting as many as they say, is how many people will have celiac disease triggered. If there is wide infection we could see a spike in celiacs being diagnosed. 

Edited March 16, 2020 by Fenrir

[Cablekie]

Yes, since your immune system will be the one fighting the virus since there is still no cure for the COVID-19. But if you don't get it by following the WHO guidelines, then it will be fine.

[cristiana]

This is the latest advice from Coeliac UK, emailed to members today.

https://www.coeliac.org.uk/information-and-support/coeliac-disease-and-coronavirus-covid-19/

It seems reduced spleenic function is an important factor affecting up to 30 per cent of us - but as this isn't really tested routinely among coeliacs, it seems we are being encouraged to adopt stringent social distancing measures where possible. 

https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

 

[Jim Rockford]

I would assume it depends on the individual and their considerations.

According to “A Canadian Celiac podcast” (http://acanadianceliacpodcast.libsyn.com/website).

 That host states that the the CCA (Canadian Celiac Association) Indicates the risk is minimal. 
 

The issue of celiacs being either immunocompromised or immunosuppressed after diagnosis, and going gluten-free, seems to be well established.

Like many aspects of Celiac disease, there are no cut and dried answers; however, it would seem we are not at a severe risk. As with most aspects of Celiac, it seems we need to be more diligent and aware vs. the non-Celiac.

 

 

[cristiana]

Hi Jim!

Thanks for posting that.

(My grandmother here in England was a great fan of your programme!  I never thought I'd be talking to you like this!)

It does sound as if we are not at a severe risk.  I know, though, that I don't feel as well as I did before I first fell ill with coeliac disease which makes me wonder if my immune system isn't as good as it was.  Mind you - that could just be an age thing!

 

[cristiana]

That is interesting.  Certainly, my own consultant told me I was immunocompromised as a coeliac (and I believe him in my own case, because I've had a lot wrong with me since long before my diagnosis and even since adopting a gluten-free diet) but I've read so much to the contrary ever since that I'm completely confused.

I'm not medically trained so I don't understand much of the science, but Coeliac UK does seem to be advising us we need to be very careful, and I certainly will try to be.

[Jim Rockford]

Ask your doctor instead of a bunch of strangers with various degrees of knowledge and panic.

There have always been lots of knee jerk reactions on this board and varying degrees of panic when dealing with simple issues (see eating out threads); So, panic or ask your doctor.

 

From Columbia University’s Celiac Disease Center:

 

As coronavirus is a new illness, there is no research specifically looking at the risk to people with celiac disease. Celiac disease is a chronic medical condition in which there appears to be an increased risk of infections with pneumococcal bacteria that cause pneumonia and herpes zoster (causing shingles). In addition, there appears to be increased risk of worse outcomes with influenza infections and an inadequate response to vaccination with hepatitis B. Still, these risks, while measureable in several studies, are small in magnitude. It is reasonable to consider that those with celiac disease, especially older individuals, may be at a small increased risk of worse outcomes with infections with this new virus.

In view of this data, individuals should closely follow the advice of the CDC given to the general population, including hand hygiene and social distancing when possible. In addition, it is important that those with celiac disease ensure they are current with vaccinations and have follow up medical care appropriate for the disease.

Back to anonymity, and reading not posting. 

Edited March 20, 2020 by Jim Rockford
More info

[Oceans]

On 3/12/2020 at 11:41 PM, Jewel Pancake said:

I read that if you have an autoimmune disorder you’re more likely to get this. I was around a lot of people been in and out the er for the past few months my immune system is weak. Because of a vitamin deficiency. I’m really nervous about this not sure if it’s true or not, has anyone else heard this?

Absolutely. As a celiac one must take a multivitamin daily for life to be safer. Celiac for 3 years and ive found that GNC puts out high quality multi that has everything you need.