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Table 1 Factors that theoretically could influence SARS-CoV-2 infection in celiac disease

From: How to manage celiac disease and gluten-free diet during the COVID-19 era: proposals from a tertiary referral center in a high-incidence scenario

HLA status There is no data suggesting that there is an altered immune response against SARS-CoV-2 virus
Immunological environment and hyposplenism There is no evidence that ILs status or their genetic variants in CeD could have any influence. Similarly, hyposplenism may not be considered as a risk factor in this case
Mucosal atrophy In case of treated and responsive CeD the mucosal state does not seem to have a role
Malabsorption and/or micronutrients deficiencies Vitamins deficit may lead to increased susceptibility to infections. Although there is no evidence concerning COVID-19, verify the nutritional state and ensure that their alimentary intake is reasonable
Presence of a refractory celiac disease The presence of this state may significantly worsen the COVID-19 outcome, inflammatory damage and malabsorption being usually present in a severe form