Related Experiment Video
Updated: Nov 29, 2025
Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
Published on: July 18, 2017
COVID-19 pandemic impact on clinical outcomes of patients with obstructive pyelonephritis
André B Silva1, Gustavo Freschi1, Raphael V Carrera1
1Department of Urology, Endourology Division, Federal University of São Paulo, Rua Napoleão de Barros, 715, 2nd floor, São Paulo, SP, 04024-002, Brazil.
Insights
The COVID-19 pandemic delayed patient presentation for acute obstructive pyelonephritis, leading to increased disease severity and longer hospital stays. This highlights the impact of the pandemic on emergency urologic care.
Area of Science:
- Urology
- Infectious Diseases
- Public Health
Background:
- Obstructive pyelonephritis is a critical urologic condition requiring immediate intervention.
- The COVID-19 pandemic significantly altered healthcare delivery and patient access to emergency services in Brazil.
- The pandemic's specific impact on acute obstructive pyelonephritis outcomes remained unclear.
Purpose of the Study:
- To evaluate the clinical outcomes of patients with acute obstructive pyelonephritis during the COVID-19 outbreak.
- To compare patient presentation and disease severity before and after the pandemic's onset.
Main Methods:
- A retrospective chart review was conducted for patients treated between June 2019 and July 2020.
- Patients were categorized into 'Pre-Covid' and 'Post-Covid' groups based on admission date.
- Demographic, pre-operative, and peri-operative data were analyzed.
Main Results:
- Patients in the Post-Covid group presented later (7.8 vs. 4.3 days) and had higher rates of SIRS (57% vs. 25%) and perirenal abscesses (13% vs. 0%).
- The Post-Covid group experienced more overall complications and a significantly longer hospital stay (7.6 vs. 3.8 days).
Conclusions:
- The COVID-19 pandemic was associated with delayed presentation and increased disease severity in patients with acute obstructive pyelonephritis.
- Patients during the pandemic required longer hospitalizations compared to the pre-pandemic period.
Purpose:
Obstructive pyelonephritis is a common urologic emergency that requires prompt decompression of the collecting system. The COVID-19 pandemic has changed patient flow and healthcare strategies at numerous emergency departments across Brazil with still unknown consequences for the population. This study sought to investigate the impact of the COVID-19 outbreak on clinical outcomes in patients with acute obstructive pyelonephritis at a tertiary academic center.
Materials And Methods:
After Institutional Review Board approval, a retrospective chart review of patients who required decompression of the collecting system due to acute obstructive pyelonephritis from June 2019 to July 2020 was conducted. Basic demographic information, pre-operative, and peri-operative data were recorded. Patients were assigned in "Pre-Covid" and "Post-Covid" groups based on the admission dates.
Results:
A total of 63 patients were included, with 40 patients in the Pre-Covid group and 23 in the Post-Covid group. Patients from the Post-Covid group presented at the ER later after symptoms onset (7.8 vs. 4.3 days; p = 0.012), had higher rates of SIRS (57% vs. 25%; p = 0.012), perirenal abscesses (13% vs. 0%; p = 0.019), overall complications (p = 0.047) and presented longer hospital length of stay (7.6 vs. 3.8; p = 0.007).
Conclusion:
During the COVID-19 pandemic, patients with acute obstructive pyelonephritis presented later for evaluation at the ER, had higher disease severity and longer hospital length of stay when compared to the pre-COVID group of patients with the same pathology.
Related Concept Videos
01:27Acute Pyelonephritis I: Introduction
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:25Urinary Tract Infection II: Pathophysiology
01:29Acute Kidney Injury II: Pathophysiology
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:17Urinary Tract Infection IV: Nursing Management