Impact of COVID-19 pandemic on STIs in Greece

Restrictive measures due to COVID-19 outbreak resulted in unprecedented modifications in healthcare services and social life. We reviewed records from two referral centres in Greece to identify newly diagnosed cases of gonorrhoea and syphilis from 1 March 2020 to 30 October 2020 and compared them with the respective numbers of the same period in 2019. The total number of new syphilis and gonorrhoea diagnoses in 2020 was 423 versus 521 in 2019. Syphilis cases in 2020 were significantly lower compared with 2019 (306 vs 340, respectively, p=0.02, 10% reduction). Similarly, there were 113 versus 179 gonorrhoea cases in 2020 and 2019, respectively (p=0.01, 36.9% reduction). The number of heterosexuals was significantly lower in 2020, compared with 2019, while the number of men having sex with men (MSM) was slightly increased. A reduction in newly diagnosed STDs was reported in many countries during COVID-19 outbreak. In Madrid, researchers reported a 73.2% and 81.4% reduction of new syphilis and gonorrhoea cases, respectively, in the first 26 weeks of 2020 compared with 2019. In Switzerland, new syphilis and gonorrhoea diagnoses were accordingly reduced by 84.8% and 16.5% in 2020 versus 2019. In China, new syphilis diagnoses in 2020 were reduced by 8.2% as compared with 2019. Data from all countries converge to the conclusion that considerably fewer STDs were diagnosed in 2020 as compared with 2019. The latter maybe attributed to limited access or unwillingness of patients to visit a hospital in the fear of COVID-19 transmission. Social distancing and banned entertainment activities may further contribute to the reduction. Interestingly, in Greece, STDs’ numbers in MSM remained unchanged in 2020 versus 2019, possibly reflecting less affected sexual behaviour in this population. Considering potential longterm consequences of undiagnosed STDs, our results highlight the need of uninterrupted testing and treatment of STDs during a pandemic.