Patient's Fear of Being Infected, Another Complication of COVID-19 Outbreak: A Lesson Learned from a Case of Life-Threatening Urolithiasis

Abstract

Background: Because of the fear of being infected with coronavirus disease 2019 (COVID-19), patients with nephrolithiasis, who choose to stay home, may suffer serious complications such as obstructive uropathy, deterioration of renal function, sepsis, and death. We present such a case that led to renal failure and necessitated emergent urologic intervention. Case Presentation: A 60-year-old Caucasian man presented with right flank pain, dizziness, and dyspnea at the emergency room. History was significant for a previous diagnosis of right renal pelvic stone that was scheduled for retrograde intrarenal surgery before the pandemic lockdown. Upon evaluation, he was found to have an elevated creatinine of 40.2 mg/dL, bilateral hydronephrosis, pericardial and pleural effusion. The patient underwent emergency hemodialysis, followed by preliminary bilateral percutaneous nephrostomy, and subsequently by ureteral stenting. He was discharged stable with the future plan for endoscopic stone management. Conclusions: In the midst of the COVID-19 pandemic, urologists should follow up all known kidney stone patients, regularly assess their condition, and prioritize those who need urgent care. Patient education and telemedicine are useful tools for this purpose and may help minimize the risk of complications during a community lockdown.

Fear of COVID-19 and Related Factors in Emergency Department Patients

“…Our study results are in line with the literature. In a case report of a patient who had kidney stones and was admitted to the ED with abdominal pain and anuria complaints, it was stated that he did not go to the hospital due to fear of COVID-19 and as a result, signs of kidney failure were developed (Romantini et al 2020 ). In a qualitative study, it was reported that most emergency room patients have a fear of contracting the virus.…”

COVID-19 effect on perioperative findings of flexible/semi-rigid ureterorenoscopic lithotripsy: A match-pair analysis

“…As patients were reluctant to go to hospital due to the risk of catching COVID-19 disease, the number of patients presenting with the complaint of renal colic was noted to be significantly reduced compared to the same months of the previous year. 13,22,23 However, the number of patients presenting with fever, urinary tract infection, and high serum creatinine and WBC were significantly increased in this period despite similar radiological findings such as degree of hydronephrosis, stone number, and size noted. 14,16 Nevertheless, data presented in these studies is highly limited by the fact that they were all conducted during the early period of the pandemic and patients were evaluated within a short period of time.…”

Lessons learned after the disruption caused by COVID-19 in the management of urolithiasis: An example of adaptation in a high-volume center

“…It has been recommended that urologists should closely follow up kidney stone patients and prioritize those who need urgent care 10 . Because elective surgeries were temporarily suspended, many procedures had backlogged.…”