Background Gastrointestinal infections represent a risk factor for functional gastrointestinal and somatoform extraintestinal disorders. We investigated the prevalence and relative risk (RR) of gastrointestinal and somatoform symptoms 5 months after SARS‐CoV‐2 infection compared with a control cohort. Methods One hundred and sixty‐four SARS‐CoV‐2 infected patients and 183 controls responded to an online questionnaire about symptoms and signs during the acute phase of the infection and after 4.8 ± 0.3 months. Presence and severity of gastrointestinal symptoms, somatization, anxiety, and depression were recorded with standardized questionnaires. Stool form and presence of irritable bowel syndrome (IBS) were also recorded. Any association between exposure to infection and symptoms was evaluated by calculating crude and adjusted RR values and score differences with 95% confidence intervals (CI). Key Results Fever, dyspnea, loss of smell/taste/weight, diarrhea, myalgia, arthralgia, and asthenia were reported by more than 40% of patients during the acute phase. Compared with controls, adjusted RRs for loose stools, chronic fatigue, and somatization were increased after infection: 1.88 (95% CI 0.99–3.54), 2.24 (95% CI 1.48–3.37), and 3.62 (95% CI 1.01–6.23), respectively. Gastrointestinal sequelae were greater in patients with diarrhea during the acute phase. Conclusions & Inferences Mild gastroenterological symptoms persist 5 months after SARS‐CoV‐2 infection, in particular in patients reporting diarrhea in the acute phase. Infected patients are at increased risk of chronic fatigue and somatoform disorders, thus supporting the hypothesis that both functional gastrointestinal and somatoform disorders may have a common biological origin.

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Ulcerative colitis (UC) is a chronic relapsing disorder of the colonic tract, characterized by a dysregulated innate and adaptive immune response to gut microbiota that contributes to the perpetuation of intestinal inflammatory processes. The Interleukin (IL) 23/IL17 axis has been reported to play a key role in UC pathogenesis promoting Th17 cells and cytokines-related immune response. Recently, the blockade of IL23/IL17 pathways has been raised enormous interest in the treatment o several chronic inflammatory disorders. In this review, we summarize the emerging results from clinical trials that evoked both promise and discouragement in IL23/IL17 axis in the treatment of UC. Targeting IL23 p40 through Ustekinumab results safe and effective to induce and maintain clinical remission, low inflammatory indexes, mucosal healing, and a better quality of life. Studies targeting IL23 p19 through Mirikizumab, Risankizumab, Brazikumab and Guselkumab are still ongoing. To date, no clinical studies targeting IL17 pathway are ongoing in UC. IL-17 targeting is thought to have a context-dependent biological effect, based on whether cytokine is selectively targeted or if its function is dampened by the upstream block of IL23.

Background and aims A similar course of COVID-19 in patients with inflammatory bowel diseases (IBD) and in the general population has been reported. However, disease prevalence in IBD patients is presently unknown. In this prospective observational study we aimed at determining SARS-CoV2 infection prevalence in IBD patients treated with biological therapy. Methods 354 sera from IBD patients under biological therapy recruited from three different locations in Italy and Germany were evaluated for antibody presence by RBD ELISA. Control groups were i) age-matched healthy subjects tested in the same time period in Milan, Italy; ii) healthy subjects collected in the pre-COVID era; iii) IBD patients under biological therapy collected in the pre-COVID era. Results 8 out of 354 patients tested positive for the anti-RBD-SARS-CoV2 IgG antibody (prevalence 2.3%). IgG positive patients’ percentage recruited from Milan was significantly higher than those recruited from other locations (prevalence 5.4% vs. 0.4% p < 0.005). IgG positive patients reported a significantly higher incidence of fever, anosmia and ageusia, and were more likely to have entered in close contact with COVID-19 positive subjects before the study enrolment. Conclusions Seroprevalence of SARS-CoV2 in IBD patients treated with biological therapy reflects values measured in the local general population. Specific symptoms and contact history with SARS-CoV2-infected individuals strongly increase the likelihood of SARS-CoV2 seropositivity.

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