Impact of COVID‐19 pandemic on patients with obstructing urinary stones complicated by infection

Abstract

Objective To assess the influence of COVID‐19‐imposed life changes on presentation and outcomes of patients with obstructing urinary stones complicated by infection. Patients and methods All patients presenting with obstructing urinary stones and infection 1 year before the pandemic (March 2019 to February 2020; n = 66) and 1 year since its onset (March 2020 to February 2021; n = 45) were enrolled. Demographics, clinical presentation, laboratory panel, stone characteristics and outcomes were compared between groups. Univariate and multivariate logistic regression models were performed for analysis. Results The COVID‐19 period was characterised by younger patients, female predominance, higher temperature at presentation and more bilateral obstructing stones (p < 0.05). The admission rate to intensive care units was double that of the pre‐pandemic period, whereas time between diagnosis and treatment was similar. The univariate analysis revealed higher rates of severe sepsis (odds ratio [OR] = 3, p = 0.01), systemic inflammatory response syndrome (SIRS) ≥ 2 (OR = 2.9, p = 0.01) and risk, injury, failure, loss of kidney function and end‐stage kidney (RIFLE) criteria ≥ 1 (OR = 2.2, p = 0.04) in the pandemic period group. The multivariate analyses revealed the COVID‐19 period as being the sole variable associated with severe sepsis (OR = 3.1, p = 0.02), SIRS ≥ 2 (OR = 3.8, p = 0.005) and RIFLE ≥ 1 (OR = 2.6, p = 0.05). Conclusions The pandemic period was characterised by a worse clinical state at presentation of patients with obstructing urinary stones complicated by infection, probably reflecting delay in arrival to emergency services.

Did the COVID-19 Pandemic Restrict Access to Emergency Urological Services: Assessment of Reorganisation Effectiveness for Hospital Treatment

“…This might be justified by the fact that even small-sized deposits can produce exaggerated symptoms of obstruction and cause patients to report to the hospital. Similar results have been reported in other studies [ 18 , 19 , 20 ]. However, Jiang et al, reported that the mean stone size among patients visiting the emergency room in the pre-COVID and COVID periods increased from 5.1 to 10.5 mm.…”

Seasonal events and journal milestones

“…Herzberg et al [6] performed a Covid-19 era study of obstructing urinary stones complicated by infection. Similar to the oncology papers using immediate pre-pandemic populations as controls, they found a significant increase in sepsis-related complications during the pandemic-assumed to reflect delayed presentation to acute care.…”