Abstract

ABSTRACTPurpose: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 (2017-2019) 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 significantly 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 significant 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.

Highlights

  • Since the onset in December 2019, the coronavirus disease 2019 (COVID-19) outbreak has spread globally [1]

  • Of 15.217 visits to the emergency room (ER) during the lockdown period, 167 (1.1%), 55 (0.36%), and 39 (0.26%) patients presented with renal colic, gross hematuria, and urinary retention, respectively

  • Our findings suggest that patients with urological emergencies across the severity spectrum abstained from prompt medical workup and treatment

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Summary

Introduction

Since the onset in December 2019, the coronavirus disease 2019 (COVID-19) outbreak has spread globally [1]. Many countries have declared a state of emergency and imposed lockdown restrictions to reduce transmission of the virus. On March 11, 2020, Israel began enforcing social distancing, and a full national lockdown was imposed from March 19 to May 4. During this period, community medical services were limited with a reduction in the number of outpatient clinic sessions, and telemedicine utilization increased significantly [2]. While the benefits of full lockdown in reducing the spread of the virus have already been seen in several countries, the short-term implications of lockdown restrictions on other medical problems, including urological emergencies, require further research

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