Risk perception and knowledge of COVID-19 in patients with celiac disease

BACKGROUND We recently demonstrated that the odds of contracting coronavirus disease 2019(COVID-19)in patients with celiac disease(CeD)is similar to that of the general population.However,how patients with CeD perceive their COVID-19 risk may differ from their actual risk.AIM To investigate risk perceptions of contracting COVID-19 in patients with CeD and determine the factors that may influence their perception.METHODS We distributed a survey throughout 10 countries between March and June 2020 and collected data on demographics,diet,COVID-19 testing,and risk perceptions of COVID-19 in patients with CeD.Participants were recruited through various celiac associations,clinic visits,and social media.Risk perception was assessed by asking individuals whether they believe patients with CeD are at an increased risk of contracting COVID-19 when compared to the general population.Logistic regression was used to determine the influencing factors associated with COVID-19 risk perception,such as age,sex,adherence to a gluten-free diet(GFD),and comorbidities such as cardiac conditions,respiratory conditions,and diabetes.Data was presented as adjusted odds ratios(aORs)RESULTS A total of 10737 participants with CeD completed the survey.From them,6019(56.1%)patients with CeD perceived they were at a higher risk or were unsure if they were at a higher risk of contracting COVID-19 compared to the non-CeD population.A greater proportion of patients with CeD perceived an increased risk of contracting COVID-19 when compared to infections in general due to their CeD(56.1%vs 26.7%,P<0.0001).Consequently,34.8%reported taking extra COVID-19 precautions as a result of their CeD.Members of celiac associations were less likely to perceive an increased risk of COVID-19 when compared to non-members(49.5%vs 57.4%,P<0.0001).Older age(aOR:0.99;95%CI:0.99 to 0.99,P<0.001),male sex(aOR:0.84;95%CI:0.76 to 0.93,P=0.001),and strict adherence to a GFD(aOR:0.89;95%CI:0.82 to 0.96,P=0.007)were associated with a lower perception of COVID-19 risk and the presence of comorbidities was associated with a higher perception of COVID-19 risk(aOR:1.38;95%CI:1.22 to 1.54,P<0.001).CONCLUSION Overall,high levels of risk perceptions,such as those found in patients with CeD,may increase an individual’s pandemic-related stress and contribute to negative mental health consequences.Therefore,it is encouraged that public health officials maintain consistent communication with the public and healthcare providers with the celiac community.Future studies specifically evaluating mental health in CeD could help determine the consequences of increased risk perceptions in this population.

Seroprevalence of celiac disease among United Arab Emirates healthy adult nationals: A gender disparity

AIM:To determine celiac disease(CD)prevalence and associated manifestations or risk factors in healthy adult Emiratis.METHODS:It is a cross-sectional prospective study,recruiting 1197(573 women and 624 men)healthy Emiratis between September 2007 and April 2008among those who went to Al Ain Hospital to undertake the prenuptial examination.Test for anti-tissue transglutaminase(tTG)IgA antibodies was used for CD diagnosis.Subjects with positive results in the anti tTG antibodies assay were also tested for anti-endomysial(EMA)IgA antibodies.A structured interview was used to collect basic demographic and clinical recall data including:information on name,contact address,age,gender,education status,previous diagnosis of CD,diagnosis of CD in 1st degree relatives and history of"chronic diarrhea,anemia,headache,hepatitis,diabetes,tumor,and thyroid disorder".RESULTS:Fourteen blood samples(1.17%;14/1197)were seropositive for CD.The latent CD seropositive patients were 13 women and 1 man and therefore the seroprevalence of CD was 1:86(14/1197)for adult Emiratis:1:44(13/573)for women and 1:624 for men.Binary logistic regression revealed that history of chronic anemia(crude OR=7.09;95%CI:2.32-21.61;P=0.003)and being a woman(OR=14.46;95%CI:1.89-110.91;P=0.001)were associated with CD seropositivity.Whereas,the thyroid disorder showed a positive association with CD seropositivity that approach statistical significance(OR=11.30;95%CI:1.32-96.95;P=0.09)and therefore was included in the multiple logistic regression analysis,which showed that CD seropositivity is independently associated only with history of chronic anemia(OR=4.58;95%CI:1.45-14.48;P=0.01)and being a woman person(OR=10.47;95%CI:1.33-82.14;P=0.026).CONCLUSION:Compared to men the CD seroprevalence among women was remarkably higher.The CD association with women and chronic anemia is of importance from a public health perspective.

肠易激综合征的饮食疗法对低可发酵性短链碳水化合物饮食的高度期望

肠易激综合征（irritablebowelsyndrome，IBS）是常见的消化系统疾病，影响全球人口的10％左右。IBS没有明确的生物标志物及根治方法，近年来引入各种治疗药物，包括抗生素（治疗假定的小肠细菌过度生长）和通过液体分泌及肠神经系统调节肠道动力的药物。虽然，这些药物有其优点，但近年来最受患者欢迎的治疗方法为饮食疗法。

乳糜泻及非乳糜泻性麦胶敏感症

乳糜泻是具有基因特异性的个体，因摄入麦胶而激发的多系统免疫异常。乳糜泻的患病率在近几十年来逐渐增加，目前在西方人群中已达1％。尽管与饮食卫生相关的多种环境因素值得怀疑，但其发病增加的原因并不明确。乳糜泻的发病机制涉及与饮食中的麦胶成分相关的原发性及适应性的免疫反应。该病的，临床表现多种多样，包括胃肠道症状、代谢性骨病、生育不能，以及其他多种多样的表现。虽然无麦胶食物对大多数患者的治疗有效，但这样的饮食令人烦恼并影响生活质量。因此。在疾病的不同阶段也需要非饮食疗法。本综述也总结了非乳糜泻性麦胶敏感症。对这一临床亚型的发病机制仍然缺乏了解，但这一现象使得无麦胶食品在人群中的应用受到重视。