Registered Sick Leave in Celiac Disease: A Register-Based Nationwide Cohort Study

The vagueness of symptoms and differences in severity in celiac disease (CeD) make it challenging to fully grasp CeD and its burden. Sick leave may be an indicator of disease burden. We aimed to assess registered sick leave before and after diagnosis of CeD in a longitudinal nationwide register-based cohort study.

All patients diagnosed with CeD between 2008 and 2017 and aged 25-60 were identified in the National Patient Register. A 1:10 matching method by age and sex was used to identify a comparison cohort without CeD. Information on registered sick leave and disability pension was obtained from the Danish Register for Evaluation of Marginalization Registry. Sick leave and disability pension were assessed on a weekly basis both by proportions and by mean weeks of annual leave.

A total of 2494 patients with CeD and 24,578 individuals without CeD were identified. We found higher proportions and mean weeks of sick leave among patients with CeD compared with individuals without CeD from 5 years before diagnosis until 5 years after, peaking in risk ratios (RRs) 2 years after diagnosis (RR: 1.58), and in disability pension 5 years after diagnosis (RR: 1.44). The relative difference in mean number of weeks of sick leave per year was highest in the year following diagnosis (mean weeks among patients with CeD 5.80, ratio of means 1.62).

We found increased levels of sick leave and disability pension among patients with CeD both 5 years before and 5 years after diagnosis. Measures to prevent the burden of CeD should be considered and explored further.