LAUSR

There are conflicting data on how COVID-19 has impacted STI epidemiology worldwide. In Rome, we observed a marked decrease in syphilis diagnoses during the first lockdown of spring 2020. Extending our previous observations, we compared syphilis diagnoses (primary/ secondary/recent) during the whole of 2020 versus those of the previous 3 years (figure 1). While diagnoses by month were homogeneous in the prepandemic period (p for trend=0.40), 2020 showed a peak in June, a sharp and atypical decline in September, returning to the usual figures in November, when Rome was in ‘soft’ lockdown. We speculate that the increase in June might reflect: (1) visit postponement by patients who, despite being symptomatic, were reluctant to attend the hospital; (2) diagnoses of infections acquired during lockdown. Overall, syphilis diagnoses were 81 in 2020 compared with mean 106 (SE: 7) in 2017–2019 suggesting, to some extent, a reduction of atrisk sexual encounters in the pandemic period.