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

Int J Clin Pract. 2021 Sep;75(9):e14452. doi: 10.1111/ijcp.14452. Epub 2021 Jun 17.


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.

MeSH terms

  • COVID-19*
  • Celiac Disease* / epidemiology
  • Disease Outbreaks
  • Gliadin
  • Humans
  • SARS-CoV-2


  • Gliadin