ABSTRACT
Background and aim: The correlation between Covid-19 and nonrespiratory bacteria is mostly unexplored. The following considerations led us to investigate a possible correlation between Hp and SARS-CoV2: both are microbial agents with a very large-scale epidemiology;both can cause GI symptoms;both can persist in the GI tract for long time [Fei Xiao, 2022];patients with pre-existing HP gastric colonization, once infected by SARS-CoV-2, complain more frequently and with greater severity of GI symptoms such as abdominal pain and diarrhea [Balamtekin, 2019];SARS-CoV-2 binds ACE-2 receptors to enter cells, which are widely expressed in the GI tract. In addition, Hp is known to increase the expression of ACE-2 receptors. This study aims to investigate, by C13 Urea BT, the prevalence of Hp infection and the DOB (delta over baseline), in pre-pandemic period (pPP), from Sept. 2017 to Dec. 2019, and during Covid-19 pandemic period (PP), from Jan. 2020 to Apr. 2022, to evaluate whether SARS-CoV-2 and Hp infection association is only due to chance or whether represents a pathogenetic correlation. Material(s) and Method(s): This is a retrospective preliminary study on 1532 randomized patients: 825 and 707 referring respectively to pPP and PP. Result(s): 316 patients underwent C13 Urea BT for the diagnosis of Hp infection: 36 out of 179 (20.11%), and 74 out of 137 (54.01%), respectively in pPP and in PP, tested positive for Hp. The DOB of patients tested during the PP was 40.4+/-17.5, significantly higher when compared to the mean value found in pPP: 17.4+/-16.5 (p=0.0001). [Figure presented] Conclusion(s): Neglecting the search for Hp, also due to difficulties encountered in this period to access BT, represents a risk condition for gastric diseases, especially considering the remarkable elevation of the prevalence and the DOB caused, somehow, by the SARS-CoV-2 virus. Particularly, the higher the DOB, the higher the bacterial load, but, more significantly, the greater the ability of the bacterial strains to produce urease: the strains with the greatest urease-activity are cagA+ strains (those capable of producing the oncogenic protein involved in the process of carcinogenesis) [Moreno-Ochoa, 2020]. Thus, it can be assumed that the higher the DOB, the greater the risk of developing serious gastric problems in the absence of treatment. So, in conclusion, Sars-Cov-2 and HP infection may influence each other. GI morphological and functional alterations due to Sars-Cov-2 infection, which can promote HP colonization and replication, need further investigation.Copyright © 2023. Editrice Gastroenterologica Italiana S.r.l.
ABSTRACT
OBJECTIVE: Celiac disease (CD) is an autoimmune disorder, characterized by increased susceptibility to bacterial and viral infections. Therefore, the CD patients could be exposed to an increased risk of contracting SARS-CoV-2, a virus for which the WHO declared a pandemic status in March 2020. This study aims to investigate the incidence of SARS-CoV-2 infection in CD patients, to assess the impact of CD on the risk of contracting this virus. PATIENTS AND METHODS: This retrospective multicentric cohort study evaluated 542 celiac patients, who answered a questionnaire concerning both the underlying disease (adherence to the gluten-free diet, residual symptoms) and the possible SARS-CoV-2 infection (swab outcome, presence and characteristics of symptoms and type of treatment received), referring to the period between 20th January 2020 and 27th October 2020. RESULTS: Five patients (0.92%) tested positive; of these, 2 were asymptomatic and 3 developed symptoms of COVID-19. The incidence of SARS-CoV-2 infection in CD patients was not significantly different from the general population. The ratio of positive/diagnostic swabs tends to be higher in CD patients than in the general population (IR: 0.15; 0.06; p=0.06), whereas the number of subjects who performed the swab in this group is significantly lower (IR: 0.06; 0.15; p<0.001). CONCLUSIONS: Although CD patients are more susceptible to infections, the incidence of SARS-CoV-2 infection in our sample was not significantly different from the general population. However, the positive/diagnostic swabs ratio seems to be higher, probably also due to the lower number of patients tested.