The Influence of SARS-CoV-2 Pandemic on the Diagnosis of Celiac Disease and Clinical Practice in Pediatric Gastroenterology

• Published in: Nutrients 2023-01, Vol.15 (3), p.559
• Main Authors: Crocco, Marco, Calvi, Angela, Canzoneri, Francesca, Malerba, Federica, Zampatti, Noemi, Chiaro, Andrea, Arrigo, Serena, Gandullia, Paolo, Proietti, Stefania, Bonassi, Stefano
• Format: Article
• Language: English
• Subjects: Approximation; Autoimmune diseases; Biopsy; Brief Report; Celiac disease; Celiac Disease - diagnosis; Celiac Disease - epidemiology; Child; Children; Clinical medicine; Communicable Disease Control; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - epidemiology; COVID-19 Testing; Delayed Diagnosis; Diagnosis; Emergency medical care; Endoscopy; Evaluation; Forecasts and trends; Gastroenterology; Gluten; Hospitals; Humans; Infections; Pandemics; Pediatric research; Pediatrics; Public health; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Statistics; Telemedicine; Time series; Viruses
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15030559

Celiac disease (CD) has a high prevalence but remains largely underdiagnosed. Although extensive studies have confirmed that children with CD do not have an increased risk of severe COVID-19, public health regulations associated with the SARS-CoV-2 pandemic may have exacerbated this problem. The aim of this study was to assess the effect of SARS-CoV-2 on the number of new-onset CD cases. Additionally, the role of SARS-CoV-2 in autoimmune diseases and its influence on clinical practice in pediatric gastroenterology were briefly reviewed. We described the data from the hospital electronic registry of new-onset CD, during the COVID-19 pandemic and 2 years before. A total of 423 children were diagnosed with CD between March 2018 and February 2022: 228 in the 2-year pre-COVID-19 period and 195 during the pandemic. The number of patients during the COVID-19 pandemic was 14.5% lower than in the previous years. The quarterly comparison of CD diagnoses showed a reduction in all quarters. A reduction in diagnoses during the lockdown and in the following months was evident and not compensated thereafter. This is the first study to evaluate the impact of SARS-CoV-2 on the diagnosis of CD in children. Further studies are necessary to improve the system of biopsy-sparing diagnosis and to evaluate the effect of the diagnostic delay. Special attention should be given to the implementation of telemedicine services.