Background: Patients with inflammatory bowel disease (IBD) may be particularly vulnerable to the effects of the novel coronavirus (Covid-19) on disease management and psychological status. This study explored psychological reactions to the Covid-19 emergency and IBD disease management in a sample of Italian patients.Methods: An online questionnaire was designed to assess general concerns, psychological reaction, disease management, socio-demographics, and clinical information with validated scales and ad hoc items. A non-probabilistic purposive sample was selected, comprised patients with IBD who belonged to the Italian Association for patients with IBD (AMICI Onlus) completed the questionnaire in April 2020. Data obtained were analyzed using descriptive statistics, student’s T-test for independent groups, and one-way ANOVA (Analysis of Variance).Results: One thousand fourteen eligible questionnaires were analyzed. Italian patients with IBD appeared to be very worried about the Covid-19 emergency (60.7%) and concerned about the risks of infection (59%). Half of the sample reported medium to high-perceived stress, and 74% had low-medium coping self-efficacy levels. One third was in a state of psychological arousal. Twenty-nine percent of patients had canceled hospital appointments for fear of contracting the virus. The majority of responders believed that belonging to the Italian Association for Patients with IBD - AMICI Onlus - is useful.Conclusions: The results revealed that this sample of Italian patients with IBD lived with medium level of stress and with inadequate coping self-efficacy regarding disease management. Accordingly, Covid-19 may affect self-management behaviors. Therefore, national and regional associations for patients with IBD, should largely support these patients in this emergency.

Background: Malnutrition is a clinically relevant yet often under-recognized complication of inflammatory bowel diseases (IBD). Evidence from non-hospitalized patients remains limited. This study provides a descriptive analysis of indicators of nutritional risk among members of the Italian IBD patients’ association and explores the association with symptoms, clinical characteristics, and access to nutritional care. Methods: A cross-sectional survey was conducted on 705 IBD patients. The questionnaire incorporated all the items required to assess nutritional risk included in the Malnutrition Universal Screening Tool (MUST) and its association with other clinical parameters. Results: Overall, 43.0% of respondents were found to be at moderate or high risk of malnutrition based on the MUST. A low BMI was observed in 25.6% of patients with CD and 22.1% of those with UC. Additionally, unintentional weight loss (UWL) occurred in 24.5% and 23.7% of CD and UC patients, respectively. In total, 30% of patients reported restricting their diet because they were afraid certain foods would worsen their symptoms. Gastrointestinal symptoms were significantly associated with MUST ≥ 2. Only 21.7% of participants reported receiving nutritional counselling. A total of 67.3% of subjects already at high nutritional risk (MUST ≥ 2) have never received any dietary recommendations. Conclusions: In this community sample of IBD patients, a considerable proportion reported indicators compatible with nutritional risk. These findings are not generalized to the general IBD population due to the dissemination through a patient association, but highlight gaps in outpatient nutritional assessment and patient education. Structured, accessible nutritional support may help address these unmet needs.