Patients with celiac disease who did not receive the pneumococcal vaccine are at high risk of getting pneumonia, according to the study, “The risk of community acquired pneumonia among 9,803 patients with coeliac disease compared to the general population: a cohort study,” published in the journal Alimentary Pharmacology and Therapeutics.
Community-acquired pneumonia, often caused by Streptococcus pneumoniae, is the most common type of pneumonia and is associated with high mortality rates worldwide. Although it mostly affects older people, other groups are also more susceptible to community-acquired pneumonia-causing pathogens, such as patients with chronic conditions, alcoholics, or patients with a compromised immune system.
Researchers have also found that patients with celiac disease are at high risk of acquiring pneumonia due to reported spleen problems, an organ that plays an essential role in the clearance of this type of bacteria in the course of initial infection. Therefore, celiac patients are included in those patients at risk to whom pneumococcal vaccination is recommended.
Now, researchers at the University of Nottingham in England analyzed patients with celiac disease within the Clinical Practice Research Datalink linked with English Hospital Episodes Statistics between April 1997 and March 2012, to quantify the risk of community-acquired pneumonia and understand whether vaccination against streptococcal pneumonia was able to modify this risk.
The investigators examined data from 9,803 patients with celiac disease and 101,755 controls. Results demonstrated that the absolute rate of pneumonia was similar in patients with celiac disease and controls. However, unvaccinated patients with celiac disease had a 28 percent increased risk of acquiring pneumonia when compared with unvaccinated controls — a risk that was limited to patients older than 65, was higher around the time of diagnosis, and was maintained for more than five years after diagnosis.
Still, only 26 percent of patients underwent vaccination upon celiac disease diagnosis, suggesting that there is an urgent need to vaccinate these patients as soon as they are diagnosed to prevent them from pneumonia events.
“As only a minority of patients with coeliac disease are being vaccinated there is a missed opportunity to intervene to protect these patients from pneumonia,” the authors concluded in their study.