SARS-CoV-2 Infection May Trigger Celiac Disease in Adolescents

SARS-CoV-2 infection has been shown to trigger the production of autoantibodies for a number of autoimmune diseases, including systemic lupus erythematous, celiac disease, and rheumatoid arthritis. Studies drawing these associations have typically been done on adults.

The results of a study were recently published on the prevalence of autoimmunity related to type 1 diabetes (T1D), celiac disease and autoimmune thyroid disease among children in Sweden between August 2021 and February 2022. The study utilized home-based capillary blood sampling to screen 2,271 children ages 6–9 and 13–16 years for disease-specific autoantibodies.

The findings revealed that 9.3% of participants were consistently positive for at least one autoantibody. Specifically, 2.6% exhibited T1D-related autoantibodies, 2.7% had celiac-associated autoantibodies, and 2.4% tested positive for autoimmune thyroid disease-related autoantibodies. Following clinical evaluations, 1.5% of the children were diagnosed with one of these autoimmune conditions: 1.1% with celiac disease, 0.3% with autoimmune thyroid disease, and 0.1% with T1D. Notably, the prevalence of autoantibodies and diagnosed cases was higher among younger children ages 6-9 years and females.

Importantly, the study did not find evidence linking SARS-CoV-2 infection to an increased risk of developing autoimmunity for T1D or AITD. This aligns with other research indicating no significant association between SARS-CoV-2 infection and the onset of these autoimmune conditions.

Authors do note an indication for a potential association between Covid infection and celiac autoantibodies in children 13-16 years of age, with four possible explanations as to why. First, those with celiac autoantibodies may have an increased susceptibility to viral infections, thereby accelerating disease. Viral infections such as SARS-CoV-2 can disrupt immune homeostasis; this loss of self-tolerance can lead to cytokine storms, furthermore inducing permeability within the gut. Because there was an observed increase of celiac disease in 13-16 year olds but not 6-9 year olds, authors point out there may be an age-specific window in which celiac disease is more likely to be triggered. This could be due to hyper-inflammation within this subset of adolescents, as well as stronger T-cell reactivity and antibody response from Covid infection. Authors also posit the psychological stress of the pandemic and pandemic-related circumstances in predisposed individuals accounting for disease progression.

Citations

Lind, A., et al. (2025). Risk of celiac disease, type 1 diabetes, and thyroid disease autoimmunity during the SARS-CoV-2 pandemic in South of Sweden: insights from the TRIAD study. Autoimmunity, 58(1), 2490491. https://doi.org/10.1080/08916934.2025.2490491