Vasile Daniel Balaban^{1, 2}, Alina Dima^3,, Catalin Augustin Dima^{1, 2}, Alina Popp^{1, 4}, Ciprian Jurcut², Mariana Jinga^{1, 2}

Background: The coronavirus disease 2019 (COVID-19) pandemic has immeasurably struck healthcare systems worldwide, generating disruptions in the care of chronic disease patients. We herein aimed to assess the impact of the COVID-19 pandemic on celiac disease (CD) patients. Materials and Methods: An online questionnaire with 46 cascade questions was designed and distributed through the social media channel of the Romanian CD patient association. Results: Altogether, 113 respondents accessed the questionnaire, of whom 95 adult CD patients with complete responses were included in the analysis. The median age of the surveyed participants was 44 years, with the majority (86.3%) being female. Despite concerns, the availability of gluten-free products was reported as being unchanged compared to before the pandemic by 3 out of 4 respondents. Also, our survey did not reveal significant changes regarding adherence to gluten-free diet during the pandemic, as assessed by Biagi score. However, 25.3% of respondents reported feelings of anxiety and 29.5% of depression, but only 3.2% benefited from psychological or psychiatric support. About one quarter of participants postponed their medical checkups due to fear of getting infected. One fifth of respondents declared having been infected with the novel coronavirus, but only 10% of them were hospitalized. One third of respondents had already gotten the COVID-19 vaccine and reported only minor side effects. Also, over half (57.9%) of survey participants declared they had not received enough information during the pandemic. Conclusions: Among our study respondents, availability and adherence to gluten-free diet was not markedly changed during the pandemic, but they were significantly impacted by the lack of CD-specific information about SARS-CoV2 infection and vaccination.

celiac disease, pandemic, COVID-19, gluten-free diet, vaccination