AN INTERNATIONAL REPORTING REGISTRY OF PATIENTS WITH CELIAC DISEASE AND COVID-19: INITIAL RESULTS FROM SECURE-CELIAC

ABSTRACT

Background: As the COVID-19 pandemic continues, there are questions about whether patients with celiac disease (CD) are at increased risk for severe outcomes. Prior studies have shown that patients with CD have a higher risk of developing zoster and complications from influenza and pneumococcal pneumonia, risks that persist after adoption of the gluten free diet. To study the outcomes of COVID-19 in patients with celiac disease, we created a secure, online, de-identified adult and pediatric reporting registry. Methods: The SECURECeliac registry (www.covidceliac.org) was established on March 31, 2020 and promoted via physician email lists, national societies, and word-of-mouth. Clinicians worldwide are encouraged to report all cases of COVID-19 in patients with celiac disease, regardless of severity. (Only confirmed cases of COVID-19, either through viral PCR swab or serology testing, are eligible to be reported in the registry.) Clinicians were counseled to report confirmed cases only after a minimum of 7 days and sufficient time had passed to observe the disease course through resolution of acute illness or death. A choropleth map to illustrate geographic differences in reported cases of COVID-19 in those with CD was created using QGIS and an interactive online website was created using ARCGIS to visualize current data by time, country, age, sex, hospitalizations, and deaths. Results: Between March 31, 2020 and November 20, 2020, there have been 84 cases of COVID-19 reported in patients with celiac disease. Countries across five continents are represented in the registry Asia, Australia, Europe, North America and South America (Figure 1). 86% of patients (N = 72) did not require hospitalization for COVID-19 while 14% did (N = 12). 1% of patients (N = 1) required ICU-level care while 1% of patients (N = 1) died from COVID-19. Patients who were hospitalized tended to be older (45.8y vs 39.4y, p= 0.2) and have at least one comorbidity (50.0% vs 31.9%, p= 0.3). Patients who were hospitalized were also less likely to adhere to a strict gluten-free diet (41.7% vs 65.3%, p=0.2). Patients with gastrointestinal symptoms were more likely to be hospitalized (66.7% vs 31.9%, p = 0.03). An online dashboard with interactive map displaying the current global distribution of patients with CD and COVID-19 is found here www.covidceliac.org/map Conclusions: Preliminary data from the SECURECeliac registry does not suggest increased risk of severe outcomes in patients with celiac disease who contract COVID-19. Gastrointestinal symptoms were associated with hospitalization for COVID-19. The registry remains open for clinicians to contribute to this reporting system so as to better define the impact of COVID-19 on patients with celiac disease and how factors such as age, comorbidities, and treatments impact COVID-19 outcomes.(Image Presented)(Table Presented)