Update on pediatric inflammatory bowel diseases epidemiology during SARS-CoV-2 outbreak:data from the Italian society of pediatric gastroenterology, epatology and nutrition registry

The SARS-CoV-2 pandemic significantly affected clinical practice worldwide. In Italy, hospital access was limited to urgent cases in 2020. The primary aim was to assess the impact of SARS-CoV-2 on pIBD in Italy during 2020 compared to 2019 and to 2021. The secondary aim was to compare characteristics of pIBD during 2019-2021 with data from previous reports. All new pIBD diagnoses from January 1st, 2019, to December 31st, 2021, were collected through the IBD registry of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and compared with data from previous studies. A total of nine-hundred-seventy-six new pIBD diagnoses were registered over a three-year period. The lowest number was recorded in 2020 (n = 267), significantly fewer than in 2019 and 2021 (p = 0.003). The mean incidence was 3.43/100000/year compared to 1.98 in 2009-2018 (p < 0.0001). The median diagnostic delay further decreased compared to previous years despite the COVID-19 outbreak, setting at 3.6 months. The overall median age at diagnosis was significantly higher than in 2009-2018 (12.8 vs 11.7 years, p < 0.001). The use of anti-TNF-alpha agents as induction therapy significantly increased during 2019-2021 (15.3%) compared to previous reports (6.6%). Conclusions: In 2020 the lowest pIBD incidence was observed, likely due to impact of the COVID-19 outbreak. A subsequent rise in incidence in 2021 and a reduction in diagnostic delay were noted, possibly due to the easing of restrictions. Compared to previous Italian studies, the period 2019-2021 showed an overall increase in pIBD incidence and a decrease in diagnostic delay. What is known: • Pediatric Inflammatory Bowel Diseases (pIBD) incidence is increasing worldwide, primarily in industrialized countries. • During SARS-CoV-2 pandemic, patients tended to postpone the use of medical cares and hospital accesses were limited to emergencies. What is new: • In Italy, during years 2019-2021, pIBD incidence increased and pIBD diagnostic delay shortened compared to the past, despite COVID-19 outbreak. • Prevalence of pIBD in adolescents during 2019-2021 turned out to be higher compared to previous reports. • Despite restrictions, the use of anti-TNF-alpha agents significantly increased compared to previous Italian reports.