Changing patterns of urologic emergency visits and admissions during the COVID-19 pandemic: a retrospective, multicenter, nationwide study

Rajwa, Paweł; Przydacz, Mikołaj; Krajewski, Wojciech; Kuffel, Błażej; Zapała, Piotr; Krzywon, Aleksandra; Cortez, Alexander Jorge; Dybowski, Bartosz; Stamirowski, Remigiusz; Jarzemski, Marcin; Drobot, Rafal B; Stelmach, Paweł; Mlynarek, Krystyna; Marcinek, Mateusz; Przudzik, Maciej; Krawczyk, Wiktor; Ryszawy, Jakub; Choragwicki, Dominik; Zapała, Łukasz; Lipa, Marcin; Późniak, Michał; Jańczak, Dawid; Słomian, Szymon; Łaszkiewicz, Jan; Nowak, Marcel; Miszczyk, Marcin; Roslan, Marek; Tkocz, Michał; Zdrojowy, Romuald; Potyka, Andrzej; Szydełko, Tomasz; Drewa, Tomasz; Jarzemski, Piotr; Radziszewski, Piotr; Słojewski, Marcin; Antoniewicz, Artur A.; Paradysz, Andrzej; Chłosta, Piotr

doi:10.5114/aoms.2020.98364

Cited by 13 publications

(20 citation statements)

References 20 publications

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“…Given the huge drop in outpatient cystoscopy (77%) after the COVID-19 outbreak revealed in the Uro-SoMe survey [11], the detection of primary and recurrent urothelial cancer was likely to be altered also in Poland. Considering inpatients, on the other hand, a drop in haematuria cases presenting as urological emergencies could at that moment be as high as 25% [14]. When compared to the 35% mean decrease in surgeries for RCC declared by responders of the UroSoMe survey [11] or the 53% decline reported in the recent EAU survey [17], the 11.7% reduction observed in our study cannot be considered more than moderate.…”

Section: Discussioncontrasting

confidence: 60%

Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland – a cross-country experience

et al. 2021

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IntroductionIn the majority of Western European countries, the coronavirus disease (COVID-19) pandemic has led to a dramatic reduction in urooncological surgeries. Our objective was to evaluate the impact of the pandemic on volume and patterns of urooncological surgery in Poland.Material and methodsThis is a retrospective analysis of 10 urologic centres in Poland. Data regarding major oncological procedures performed after the COVID-19 pandemic outbreak (March 15, 2020 – May 31, 2020) were evaluated and compared with data from the respective period in 2019.ResultsBetween March 15, 2020 and May 31, 2020, a total of 968 oncological procedures were performed in participating centres. When compared to the respective period in 2019 (1063 procedures) the overall number of surgeries declined by 8.9%. The reduction was observed for transurethral resection of bladder tumour (TURBT) (20.1%) and partial nephrectomies (PN) (16.5%). Surgical activity considering radical nephrectomy (RN), nephroureterectomy (NU), and radical prostatectomy (RP) remained relatively unchanged, whereas radical cystectomy (RC) burden showed a significant increase (90.9%). Characteristics of patients treated with TURBT, RC, NU, PN, and RN did not differ significantly between the compared periods, whereas RP in the COVID-19 period was performed more frequently in patients with a higher grade group (p = 0.028) and positive digital rectal examination (p = 0.007).ConclusionsSurgical activity for urological cancers in Poland has been maintained during the first wave of the COVID-19 pandemic. The Polish strategy in the initial period of the COVID-19 crisis mirrors the scenario of hard initial lockdown followed by adaptive lockdown, during which oncological care remained undisrupted and did not require particular priority triage.

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Section: Discussioncontrasting

confidence: 60%

Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland – a cross-country experience

et al. 2021

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“…Our findings support several recent reports. In their multicenter study, Rajwa et al found no differences in the laboratory parameters of 3883 patients with renal colic, hematuria, or urinary retention between the 2020 pandemic and 2019 reference periods in Poland (16). In a comparison of patient's characteristics before any restrictions and during the severe lockdown, no differences were found in levels of creatinine, Hb, CRP, and WBC.…”

Section: Discussionmentioning

confidence: 94%

Trends in urological emergencies in the Era of COVID-19

et al. 2021

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Purpose: To evaluate trends in emergency room (ER) urological conditions during COVID-19 pandemic lockdown. Materials and Methods: Retrospective analyses of renal colic, hematuria, and urinary retention in ER's admissions of a tertiary hospital during the lockdown period (March 19 to May 4, 2020) in Israel. Patient's demographics and clinical characteristics were compared to those in corresponding periods during 2017-2019, with estimated changes in ER arrival and waiting times, utilization of imaging tests, numbers of hospitalizations, and urgent procedure rates. Results: The number of ER visits for renal colic, hematuria, and urinary retention decreased by 37%, from an average of 451 (2017)(2018)(2019) to 261 patients (2020). Clinical severity was similar between groups, with no major differences in patient's age, vital signs, or laboratory results. The proportion of ER visits during night hours increased signifi cantly during lockdown (44.8% vs. 34.2%, p=0.002). There was a decrease in renal colic admission rate from 19.8% to 8.4% (p=0.001) without differences in urgent procedures rates, while the 30-day revisit rate decreased from 15.8% to 10.3% during lockdown (p=0.02). Conclusions: General lockdown was accompanied by a signifi cant decrease in common urological presentations to the ER. This change occurred across the clinical severity spectrum of renal colic, hematuria, and urinary retention. In the short term, it appears that patients who sought treatment did not suffer from complications that could be attributed to late arrival or delay in treatment. The long-term implications of abstinence from seeking emergent care are not known and require further investigation.

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“…The incidence of SARS-CoV-2 infection is equal in both sexes; however, disease severity and progression rates are approximately three times higher in the male gender [1][2][3]. This sex-specific discrepancy can potentially be explained by the mechanism of SARS-CoV-2 entry into human host cells.…”

Section: Introductionmentioning

confidence: 99%

Association between SARS-CoV-2 infection and disease severity among prostate cancer patients on androgen deprivation therapy: a systematic review and meta-analysis

et al. 2021

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Purpose Androgen-regulated enzymes such as the angiotensin-converting enzyme 2 (ACE2) and the transmembrane serine protease 2 (TMPRSS2) are involved in the SARS-CoV-2 infection process. The expression of TMPRSS2 and its fusion gene, which are increased in the epithelium of the human prostate gland during prostate carcinogenesis, are regulated by androgens. Our goal was to assess the risk of the SARS-CoV-2 infection and the severity of the disease in PCa patients treated with androgen deprivation therapy (ADT). Methods We conducted a systematic review and meta-analysis according to PRISMA guidelines. We queried PubMed and Web of Science databases on 1 July 2021. We used random- and/or fixed-effects meta-analytic models in the presence or absence of heterogeneity according to Cochrane’s Q test and I2 statistic, respectively. Results Six retrospective studies (n = 50,220 patients) were selected after considering inclusion and exclusion criteria for qualitative evidence synthesis. Four retrospective studies were included to assess the SARS-CoV-2 infection risk in PCa patients under ADT vs. no ADT and the summarized risk ratio (RR) was 0.8 (95% confidence intervals (CI) 0.44–1.47). Five retrospective studies were included to assess the severity of coronavirus disease 2019 (COVID-19) in PCa patients under ADT versus no ADT and the summarized RR was 1.23 (95% CI 0.9–1.68). Conclusion We found a non-significant association between the risk of SARS-CoV-2 infection and COVID-19 severity in PCa patients treated with ADT. However, our results suggest that during the COVID-19 pandemic PCa patients can safely undergo ADT as a cancer therapy without worsening COVID-19 risk and trajectory.

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Changing patterns of urologic emergency visits and admissions during the COVID-19 pandemic: a retrospective, multicenter, nationwide study

Cited by 13 publications

References 20 publications

Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland – a cross-country experience

Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland – a cross-country experience

Trends in urological emergencies in the Era of COVID-19

Association between SARS-CoV-2 infection and disease severity among prostate cancer patients on androgen deprivation therapy: a systematic review and meta-analysis

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