A negative fallout of COVID-19 lockdown in Italy: Life-threatening delay in the diagnosis of celiac disease

Catassi, Giulia N.; Vallorani, Martina; Cerioni, Federica; Lionetti, Elena; Catassi, Carlo

doi:10.1016/j.dld.2020.05.016

Cited by 24 publications

(23 citation statements)

References 8 publications

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“…During the COVID‐19 pandemic, the prevalence of SARS‐CoV‐2 infection in patients with CD, novel diagnostic approaches for CD during the pandemic period, worse clinical status due to delay admissions or lower diagnostic rate due to decreased admission have been reported. 16 , 17 , 18 , 19 , 20 …”

Section: Discussionmentioning

confidence: 99%

New‐onset celiac disease in children during COVID‐19 pandemic

et al. 2021

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Aim We aimed to analyse the influence of the COVID‐19 pandemic on the frequency and clinical presentation of celiac disease. Methods The study included the patients with celiac disease since January 2008. They were divided into 2 groups (diagnosed in pre‐pandemic [January 2008 and February 2020] [ n = 148] and in pandemic period [March 2020 and June 2021] [ n = 47]). Clinical and histological findings were compared between groups. Additionally, data about severe acute respiratory syndrome coronavirus 2 infection were obtained in subgroup patients ( n = 22) with celiac disease diagnosed during pandemic period. Results The number of patients per year (12.1–37.6) and the percentage of patients who were diagnosed with celiac disease/total endoscopy were increased during the pandemic period (2.2% vs. 10%, p < 0.00001). The association of celiac disease with type 1 diabetes mellitus was significantly high in pandemic period (4% vs. 17%, p = 0.002). Frequency of moderate‐severe mucosal lesions was low in pandemic period (42.4% vs. 81.7%, p = 0.0001). Clinical and laboratory markers for the past severe acute respiratory syndrome coronavirus 2 infection were found in 36.3% of patients diagnosed during the pandemic period. Conclusion It seems that the frequency of celiac disease and its association with type 1 diabetes mellitus is increased during the COVID‐19 pandemic in children.

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Section: Discussionmentioning

confidence: 99%

New‐onset celiac disease in children during COVID‐19 pandemic

et al. 2021

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“…In this respect it is noteworthy to highlight the possible consequences of the reduction of access to healthcare service during COVID-19 pandemic such as increase risk for delayed diagnosis and severe illness presentation even of usually benign gastrointestinal disorders. It is emblematic the two cases of coeliac disease (CD) presented with coeliac crisis, a life-threatening condition which is almost completely disappeared in developed countries, due to reduce access to healthcare service or fear to attend hospital ( 98 , 99 ).…”

Section: Impact Of Covid-19 On Pediatric Gastroenterologymentioning

confidence: 99%

SARS-CoV-2 and the Gastrointestinal Tract in Children

et al. 2021

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Coronavirus disease 2019 (COVID-19), caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is predominantly a respiratory disease. However, its significant impact on the gastrointestinal (GI) system is now well-known. SARS-CoV-2 enters cells via the angiotensin-converting enzyme-2 (ACE-2) receptor, which is abundantly expressed on lung cells, but also on enterocytes. Several etiopathogenetic mechanisms have been postulated to explain the GI involvement in COVID-19, including loss in intestinal absorption, microscopic mucosal inflammation and impaired ACE-2 function, which plays a significant role in maintaining gut homeostasis. In children the GI manifestations include anorexia, nausea, vomiting, diarrhea and abdominal pain, which may represent the earliest presenting symptoms of the disease. However, although rare, a significant GI mucosal inflammation, such as terminal ileitis mimicking an atypical appendicitis, and other GI manifestations have been reported. COVID-19 pandemic has posed a significant challenge in healthcare provision in term of ability in providing safe diagnostic procedures, face-to-face consultations, and offering comprehensive care. For instance, changes in health services have raised the risk of empirical or sub-optimal management of chronic GI disorders such as inflammatory bowel disease (IBD) due to delayed endoscopic and clinical assessment. This review will discuss the acute GI involvement in COVID-19 in children and reflect on challenges and major changes observed in clinical practice during COVID-19 pandemic by sharing both the published literature and personal experience. We also suggest potential strategies for providing optimal gastroenterology care during this unprecedented era.

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“…11 In this way, the damage occurring in the epithelial barrier of COVID-19 patients could contribute to the development of CD. 12 During the COVID-19 pandemic, prevalence of infection in CD patients has been described in adults 13 and children 14 ; new diagnostic approaches for CD have been proposed, 15 and lower diagnosis rate 16 and worse clinical status 17 have been described, but no hypothesis on the future of CD are present in literature.…”

Section: Per S Pec Tive Smentioning

confidence: 99%

COVID‐19 and celiac disease: A pathogenetic hypothesis for a celiac outbreak

et al. 2021

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Background A growing body of evidence supports the intestinal trophism of SARS‐CoV‐2, with ciliated cells and intestinal enterocytes being target cells because of the high expression of ACE2 and TMPRSS2. Indeed, COVID‐19 promotes a “cytokine storm” in the intestinal mucosa: the resulting epithelial damage leads to increased barrier permeability, allowing the passage of gliadin in the intestinal lamina. Methods Based on current literature, we hypothesize the role of COVID‐19 as a potential trigger factor for celiac disease in predisposed patients. Conclusions Genetically predisposed patients could be more likely to develop celiac disease following SARS‐CoV‐2 infection, making COVID‐19 a candidate culprit for a potential outbreak of celiac disease in the forthcoming future.

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A negative fallout of COVID-19 lockdown in Italy: Life-threatening delay in the diagnosis of celiac disease

Cited by 24 publications

References 8 publications

New‐onset celiac disease in children during COVID‐19 pandemic

New‐onset celiac disease in children during COVID‐19 pandemic

SARS-CoV-2 and the Gastrointestinal Tract in Children

COVID‐19 and celiac disease: A pathogenetic hypothesis for a celiac outbreak

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