Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110 029, India.
Department of Home Science, University of Delhi, New Delhi, 110 001, India.
Indian J Gastroenterol. 2021 Dec;40(6):613-620. doi: 10.1007/s12664-021-01213-4. Epub 2021 Dec 7.
Lockdown and restricted mobility due to the pandemic of corona virus disease 2019 (COVID-19) has severely affected the continuity of healthcare of patients with acute and chronic diseases. We evaluated the impact of COVID-19 on the adherence to gluten-free diet (GFD), symptom control, and quality of life (QOL) in patients with celiac disease (CeD).
A questionnaire, consisting of both ad-hoc and validated questions, was created after review of literature, group discussions, and expert meetings. Standardized questionnaires namely CeD adherence test (CDAT), celiac symptom index score, and CeD-related QOL were used. The web-based questionnaire was sent to 3130 patients via social media and 452 responses (14.4%) were received. Also, additional 68 patients (not available on any social media application) were interviewed telephonically by a trained dietitian.
Overall, 505 patients (females: 318; mean age: 24.1±14.2 years) were included. While only 6.7% (n = 34) had poor compliance to GFD (CDAT > 17) before COVID-19 pandemic, it almost doubled to 12.6% (n = 64) during the COVID-19 pandemic times (p = 0.02). Furthermore, 4.9% (n = 25) of patients were diagnosed contacting COVID-19. Interestingly, 73.2% (n = 370) patients preferred online appointment than physical appointment. Most common difficulties faced during lockdown period were high delivery charges for getting gluten-free (GF) food at home (54.4%), increased prices of regular GF food (43.1%), and travelling long distance to arrange GF food (44.9%).
The COVID-19 pandemic has substantially affected the adherence, symptom control, and QOL in patients with CeD, attributable to unavailability, shortage of money, and heightened cost of GF food. The pandemic has offered an opportunity to practice teleconsultation approach for patients with CeD.
由于 2019 年冠状病毒病（COVID-19）大流行导致的封锁和行动受限，严重影响了急性和慢性疾病患者的医疗保健连续性。我们评估了 COVID-19 对乳糜泻（CeD）患者坚持无麸质饮食（GFD）、症状控制和生活质量（QOL）的影响。
在文献回顾、小组讨论和专家会议之后，创建了一个由特定问题和经过验证的问题组成的问卷。使用了标准化问卷，即乳糜泻依从性测试（CDAT）、乳糜泻症状指数评分和乳糜泻相关 QOL。通过社交媒体向 3130 名患者发送了网络问卷，收到了 452 份（14.4%）回复。此外，还通过受过培训的营养师对另外 68 名（未在任何社交媒体应用程序上可用）患者进行了电话访谈。
总体而言，共纳入 505 名患者（女性：318 名；平均年龄：24.1±14.2 岁）。虽然在 COVID-19 大流行之前只有 6.7%（n=34）的患者对 GFD 依从性差（CDAT>17），但在 COVID-19 大流行期间，这一比例几乎翻了一番，达到 12.6%（n=64）（p=0.02）。此外，有 4.9%（n=25）的患者在接触 COVID-19 后被诊断出患有乳糜泻。有趣的是，73.2%（n=370）的患者更喜欢在线预约而不是物理预约。在封锁期间，患者面临的最常见困难是在家获得无麸质（GF）食品的高运费（54.4%）、常规 GF 食品价格上涨（43.1%）和长途旅行安排 GF 食品（44.9%）。
COVID-19 大流行严重影响了乳糜泻患者的依从性、症状控制和 QOL，这归因于 GF 食品的不可用、短缺和成本增加。大流行为乳糜泻患者提供了实践远程咨询方法的机会。
