P268 IBD and Covid-19 in italy: comparisons between first and second pandemic wave
Bezzio, C.(1);Costa, S.(2);Armuzzi, A.(3);Furfaro , F.(4);Ardizzone, S.(5);Milla, M.(6);Bossa, F.(7);Orlando, A.(8);Caprioli, F.A.(9);Castiglione, F.(10);Viganò, C.(11);Ribaldone, D.G.(12);Zingone, F.(13);Monterubbianesi, R.(14);Imperatore, N.(15);Festa, S.(16);Daperno, M.(17);Scucchi, L.(18);Ferronato, A.(19);Pastorelli, L.(20);Balestrieri, P.(21);Ricci, C.(22);Cappello, M.(23);Felice, C.(24);Coppini, F.(25);Alvisi, P.(26);Gerardi, V.(27);Variola, A.(28);Mazzuoli, S.(29);Lenti, M.V.(30);Alessandro, S.(31);Buda, A.(32);Micheli, F.(33);Ciardo, V.(34);Casella, G.(35);Viscido , A.(36);Bodini, G.(37);Fiorino, G.(4);Vernero, M.(2);Saibeni, S.(1);
(1)Rho Hospital- ASST Rhodense, Gastroenterology Unit, Rho, Italy;(2)University of Pavia, Department of medical sciences- Gastroenterology unit, Santena, Italy;(3)Fondazione Policlinico Universitario Gemelli IRCCS, CEMAD- IBD Unit- Internal Medicine and Gastroenterology Unit- Department of Medical and Surgical Sciences-, Rome, Italy;(4)IRCCS Humanitas Research Hospital, IBD Unit-, Rozzano, Italy;(5)ASST Fatebenefratelli Sacco, Gastroenterology Unit -, Milan, Italy;(6)Azienda ospedaliero-universitaria Careggi, IBD Referral Center- Gastroenterology Department., Florence, Italy;(7)Fondazione IRCCS Casa Sollievo della Sofferenza -, Gastroenterology and Endoscopy Unit-, San Giovanni Rotondo, Italy;(8)Ospedale Cervello, Gastroenterology Unit, Palermo, Italy;(9)Fondazione IRCCS Ca' GrandaOspedale Maggiore Policlinico, Gastroenterology and Endoscopy Unit-, Milan, Italy;(10)University Federico II of Naples, Gastroenterology- Department of Clinical Medicine and Surgery, Naples, Italy;(11)San Gerardo Hospital, Gastroenterology Unit-, Monza, Italy;(12)Università di Torino- Turin., Division of Gastroenterology- Department of Medical Sciences-, Turin, Italy;(13)DISCOG- University Hospital- Padova, Department of Surgical- Oncological and Gastroenterological Sciences -, PAdova, Italy;(14)Azienda Ospedaliera San Camillo Forlanini, Gastroenterology and Endoscopy Unit-, Rome, Italy;(15)AORN Antonio Cardarelli of Naples- Naples, Gastroenterology and Endoscopy Unit, Rome, Italy;(16)San Filippo Neri Hospital- Rome, IBD Unit-, Rome, Italy;(17)Mauriziano Hospital- Turin, Gastroenterology Unit-, Turin, Italy;(18)Ospedale Alto Vicentino- AULSS 7-, Department of Systems Medicine- University Tor Vergata- Rome- 21UOSD Endoscopia Digestiva -, Vicenza, Italy;(19)Ospedale Alto Vicentino- AULSS 7-, UOSD Endoscopia Digestiva, Vicenza, Italy;(20)IRCCS Policlinico San Donato-, Gastroenterology Unit, San Donato Milanese, Italy;(21)Policlinico Campus Bio Medico, Gastroenterology and Endoscopy Unit-, Roma, Italy;(22)Spedali Civili Hospital- University of Brescia- Brescia, Gastroenterology Unit-Clinical and Experimental Sciences Department -, Brescia, Italy;(23)University of Palermo, Gastroenterology and Hepatology Section Promise-, Palermo, Italy;(24)University of Padua, Department of internal medicine, Padova, Italy;(25)Azienda Ospedaliero Universitaria Pisana, Gastroenterology Unit-, Pisa, Italy;(26)Maggiore Ospedale Maggiore di Bologna, Pediatric Gastroenterology Unit-, Bologna, Italy;(27)Poliambulanza Foundation, Gastroenterology Unit-, Brescia, Italy;(28)IRCCS Sacro Cuore Don Calabria- Negrar, Gastroenterology Unit, Verona, Italy;(29)Ospedale Mons. Dimiccoli-, Gastroenterology Unit-, Barletta, Italy;(30)IRCCS San Matteo Hospital Foundation- University of Pavia-, Department of Internal Medicine-, PAvia, Italy;(31)Humanitas University, Department of Biomedical Sciences-, Milan, Italy;(32)S. Maria del Prato Hospital- Feltre- Italy., Department of Gastrointestinal Oncological Surgery- Gastroenterology and Endoscopy Unit-, Feltre, Italy;(33)Sapienza University of Rome- Italy, Endoscopy Unit- Sant'Andrea Hospital- Faculty of Medicine and Psychology-, Rome, Italy;(34)S. Antonio Hospital-, Gastroenterology Unit-, San Daniele del Friuli- Italy., Italy;(35)ATS Brianza- Limbiate-, Gastroenterology Unit, Monza Brianza- Italy, Italy;(36)University of L'Aquila-, Gastroenterology Unit- Department of Life- Health and Environmental Sciences-, L'Aquila, Italy;(37)Internal Medicine Department- Genoa University- Italy, Gastroenterology chair-, Genova, Italy; Italian Group for the study of Inflammatory Bowel Disease (IG-IBD)
Background
Coronavirus disease 2019 (COVID-19), had two pandemic waves in 2020, respectively in April and November. In the general population, the first wave has been characterized by a higher prevalence in Northern Italy and a higher mortality rate compared to the second one. The aim of this study was to compare the characteristics of IBD patients and negative outcomes of COVID-19 (pneumonia, hospitalization, ventilatory support, death) between the two pandemic waves in Italy.
Methods
Prospective observational cohort study. Patients with diagnosis of IBD and confirmed SARS-CoV-2 infection were enrolled. Differences between first and second wave were tested for significance using the Student’s t test and Fisher’s test, as appropriate. A two-tailed p value <0.05 was indicative of statistical significance.
Results
We enrolled 937 IBD patients from 47 participating IBD centres across Italy (219 in the first wave, 718 in the second wave). There were no significant differences between the first and the second wave in terms of age (46.3 ± 16.0 vs. 44.1 ± 15.5 years, p=0.06) and gender (female 45.7% vs. 48.2%, p= 0.54). In the first wave, a lower percentage of patients was affected by Crohn’s disease (CD): 92 (42.0%) vs. 399 (55.6%) (p<0.001) while no differences were observed for disease clinical activity: 97/219 (44.3%) vs. 280/718 (38.9%) in the first and second wave, respectively (p=0.18). Regarding biologic therapy, the percentage of patients on biologics in the two waves was similar: 119/219 (54.3%) vs. 393/718 (54.7%) (p=0.94), without differences in anti-TNFalpha, anti-integrins and anti-IL12/23 distribution. During the first wave, a significantly higher percentage of patients were from Northern Italy compared to Central-Southern Italy: 171/219 (78.1%) vs. 387/718 (53.9%), respectively (p<0.001). Overall, COVID-19 negative outcomes were significantly higher in the first wave compared to the second one: 110 (50.2%) vs. 95 (13.2%), respectively (p<0.001). Also the single negative outcomes were significantly higher in the first wave: 61/219 (27.8%) vs. 84/718 (11.7%) had pneumonia, 62/219 (28.3%) vs. 76/718 (10.6%) required hospitalization, 26/219 (11.9%) vs. 39/718 (5.4%) required ventilatory support, and 12/219 (5.5%) vs. 13/718 (1.8%) died (Figure 1). 
Conclusion
IBD patients had higher number of COVID-19 negative outcomes in the first wave than in second wave. In the first wave, a significantly higher percentage of patients were from Northern Italy, but no significant differences in negative outcomes were observed in comparison with those from Central- Southern Italy. Overall, findings in IBD population are coherent with those observed in the general population.