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

Trovato, Chiara Maria; Montuori, Monica; Pietropaoli, Nicoletta; Oliva, Salvatore

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.