Trends in urological emergencies in the Era of COVID-19

Abstract

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.

Serum levels of prostate specific antigen (PSA) after primary vaccination with BNT162b2

“…Overall, our results do not support the evidence provided by Frumer et al 1 that serum PSA levels may increase after administration of a primary cycle of BNT162b2 vaccine. On the contrary, we found that BNT162b2 vaccine may also have a beneficial effect on prostate biology and function, by reducing circulating PSA levels.…”

“…Serum PSA levels were not significantly different from baseline (median: 0.9 ng/mL; IQR: 0.61-1.88 ng/mL) after the first BNT162b2 dose (median: 0.7 ng/mL; IQR: 0.48-1.26 ng/mL; p=0.074), and were even lower than at baseline after the second BNT162b2 dose (median: 0.7 ng/mL; IQR: 0.39-1.29 ng/mL; p=0.001). Our results suggest that the BNT162b2 vaccine may also have a beneficial effect on prostate biology and function, by reducing circulating PSA levels Frumer et al, 1 have recently reported that serum levels of prostate-specific antigen (PSA) increased significantly from baseline in recipients of 1 and 3 doses of the Coronavirus Disease 2019 (COVID-19) vaccine BNT162b2 (Pfizer-BioNTech, Mainz, Germany).…”

Urological stone disease: a 5‐year update of stone management using Hospital Episode Statistics

“…Lockdown was associated with a reduction of visits to the emergency department for renal colic, haematuria and urinary retention of 37%, decreasing from an average of 451 (2017–2019) to 261 patients (2020) in a study conducted in Israel. The renal colic admission rate also dropped from 19.8% to 8.4% [28]. A similar analysis was conducted in Italy during the lockdown period between March and April 2020, showing a significant reduction in symptomatic ureteral lithiasis admission of 51.2%.…”

Changes in epidemiology of patients visiting emergency departments during the early COVID-19 pandemic period

“…Some studies showed a difference in the number of patients and severity of the condition of patients visiting the ED according to the time of day [26,27]. During COVID-19 period, there was one study showing that more pregnancy patients come to the ED at night-time due to obstetric emergencies [28], and in another study, that the number of urological emergency patients also increased at night-time [29]. Also, because there is no place except ED to receive treatment at night, we predicted that the proportion of patients visiting the EDs in the night-time during the COVID-19 period would increase compared to the pre-COVID-19 period.…”