The impact of the coronavirus disease 2019 pandemic on the utilisation of emergency urological services

Abstract

Objectives To compare the number of patients attending the Urology Emergency Department (ED) of the Centro Hospitalar Universitário do Porto (CHUP), as well as their demographic characteristics, the reasons for admission, the clinical severity under the Manchester triage system (MTS), and the need for emergency surgery or hospitalisation, during the coronavirus disease 2019 (COVID‐19) pandemic and the equivalent period in 2019. Patients and methods Data were collected from patients attending the Urology ED of the CHUP over 3 weeks, from 11 March to 1 April 2020, and from the same period in the previous year (from 11 March to 1 April 2019). Results During the pandemic, 46.4% fewer patients visited our urological ED (122 vs 263). There was no significant difference in the mean age or the number of old patients (aged ≥65 years) between the two periods. However, significantly fewer female patients sought emergency urological services during the COVID‐19 pandemic period (32.7% vs 14.8%, P < 0.05). No significant differences were noted between different clinical severity groups under the MTS. In 2019, significantly less patients required hospitalisation. The most common reasons for admission, during both periods, were haematuria, renal colic and urinary tract infections. The authors recognise that the study has several limitations, namely, those inherent to its retrospective nature. Conclusion COVID‐19 significantly influenced people’s urological care‐seeking behaviour. Understanding the present situation is helpful for predicting future urological needs. Based on the results of this study, we have reason to speculate that people’s requirements for urological services might grow explosively in the post‐COVID‐19 period. There should be further studies about the real state of long‐term urological services and the consequences that this pandemic may have in terms of morbimortality not directly related to the severe acute respiratory syndrome coronavirus 2.

What has changed during the state of emergency due to COVID-19 on an Academic Urology Department of a Tertiary Hospital in Portugal

“…Furthermore, in our sample, we were able to observe a reduction in urgent causes to attend the ED considered less serious, such as non-complicated UTI or renal colic, as also pointed out by Madanelo et al 5 Probably, a significant proportion of this reduction is due to the fact that some of the patients with mild and nonurgent conditions were afraid to attend the ED because of the pandemic. Additionally, the percentage of cases requiring emergency surgery and hospitalization, such as pyonephrosis, or hydronephrosis with acute kidney injury, was higher during COVID-period.…”

“…As expected, the Urology Department experienced an noticeable reduction, in elective surgeries, diagnostic urologic examinations, as well as in the number of patients who attended the Urology Emergency Department, as already reported by others. 5 , 6 …”

The Impact of COVID-19 on a Tertiary Care Pediatric Emergency Department

“…However, some recent preliminary data estimated a reduction up to 70-80% in the number of visits in pediatric ED during the COVID-19 outbreak (13). This seems to be con rmed by similar trends observed for adult hospital care services (14,15). According to the results of a retrospective analysis involving 15 Italian Cardiac Intensive Care Units, a substantial decrease in the admission rate for myocardial infarction was shown in the month of March 2020 (13.3 vs 18.9 hospitalizations per day in the preceding year) (15).…”

Effects of COVID-19 pandemic on general surgical emergencies: are some emergencies really urgent? Level 1 trauma center experience

“…One of similar the features of these emergencies were that they are in the emergency surgery category that requires intervention within several hours or immediately which shows high mortality if early intervention is not performed [ 15 ]. Similarly, in a study by Madelona et al [ 16 ], although there was a decrease in total urological emergencies, number of admissions requiring immediate intervention such as testicular torsion, acute obstructive pyelonephritis and acute obstructive renal injury did not decrease. These results reveal that patients who really need emergency surgery are applied to the hospital during pandemic.…”