Celiac disease and COVID-19: Leveraging health registries for crucial insights and public health strategies

Background: Celiac disease is an immune-mediated disorder triggered by gluten in genetically predisposed individuals, characterized by the presence of specific antibodies and inflammation of the small intestine. This study aims to assess the risk of SARS-CoV-2 infection and clinical outcomes among individuals with celiac disease compared to the general population using administrative data from health registries. Methods: This retrospective case-control study was conducted in the Marche region, Italy, using the Celiac Disease Registry and the Italian National Monitoring System for COVID-19, from February 25, 2020, to March 31, 2021. Propensity score matching (1:1) was applied to compare celiac patients and controls based on age, sex, residence. Socio-demographic variables, chronic conditions, clinical outcomes were assessed. Results: Among 4488 celiac patients, 209 (4.65 %, 95 % CI: 4.05–5.31 %) contracted COVID-19. The infection rate in the celiac group (4.65 %) was similar to that in the non-celiac (4.43 %) (OR: 1.05, 95 % CI: 0.91–1.21, p = 0.49). Hospitalizations occurred in 7.2 % of non-celiac patients and 2.9 % of celiac patients (p = 0.015). After propensity score matching, 417 individuals were included in the analysis, showing no significant differences in clinical outcomes, including hospitalization and mortality, between the groups (p > 0.05). Conclusions: By integrating data from the Celiac Disease Registry and COVID-19 Monitoring System, we conducted a comprehensive analysis, providing valuable insights with minimal resource investment compared to interview-based studies. The findings suggest that celiac patients do not require additional COVID-19 precautions beyond standard public health measures, supporting the use of registries for informed healthcare decision-making.