Review for 10.1186/s12876-020-01524-4 (2020)

Reviewer’s report
Title: 
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
Version: 
0 
Date: 
02 Sep 2020
Reviewer's report:
This narrative review deals with a very current issue related to the management
of coeliac disease during the COVID-19 era and aims to provide some practical
suggestion from the perspective of a centre in a highly hit scenario. 
Overall, the manuscript is easy to follow, although some stylistic and lexical
inaccuracies can be found throughout the text.
The main criticism to this review is the lack of solid scientific evidences about
COVID-19 in coeliac patients, which simply does not allow drawing any
definitive conclusions/recommendations. Indeed, the suggestion by the Authors
is mainly speculative. Therefore, I would suggest to change the word
'recommendations' with the word 'proposals'. Moreover, some points relevant to
everyday clinical management of coeliac patients during the COVID-19 era are
missing and/or not adequately addressed. These include the following points,
which I suggest to be more extensively discussed:
- Taking into consideration the reconfiguration of the endoscopic services due to
COVID-19, could the diagnostic approach to the diagnosis of coeliac disease be
shifted to a no-biopsy strategy in selected patients? 
- Telemedicine has been suggested as a potential new tool for the follow-up of
patients on a long-term GFD [please see, Siniscalchi et al, DLD 2020]. Could the
Authors comment on this?
Minor concerns:
-ABSTRACT: the Authors write: 'we want to support gastroenterologist and
nutritionists in the management of CeD patients'. I would suggest to write 'we
aim to'
-BACKGROUND, line 1: I would delete the words 'In the last two months',
since the pandemic is still ongoing
-BACKGROUND, line 24-25: 'the serological presence of autoantibodies (anti
tissue tranglutaminase IgA and IgG)'. I would add also IgA endomysial
antibodies. Class IgG TTG and EmA are relevant only for patients with total
IgA deficiency, therefore I would amend accordingly or delete IgG. 
-The paragraph on "Gluten-free diet status and lifestyle during SARS-CoV2
infection" is rather redundant and gives the impression that there is nothing
different from what is usually done outside the epidemic context.
In conclusion, I think that the manuscript can be accepted only upon major
extensive revisions.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
No
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
No