The COVID-19 pandemic - what have urologists learned?
Benedikt Ebner1, Yannic Volz1, Jan-Niclas Mumm1
1Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
Insights
The coronavirus disease 2019 (COVID-19) pandemic can cause genitourinary tract damage, including acute kidney injury and testicular issues. Urologists play a key role in managing these COVID-19 complications.
Area of Science:
- Urology
- Virology
- Public Health
Background:
- The COVID-19 pandemic poses significant public health and economic challenges.
- While respiratory effects are well-known, COVID-19 frequently impacts the genitourinary tract.
- The angiotensin-converting enzyme 2 (ACE2) receptor's high expression in the genitourinary tract increases susceptibility to SARS-CoV-2 cell damage.
Purpose of the Study:
- To highlight the urological manifestations and complications of COVID-19.
- To discuss the potential long-term damage to the genitourinary system.
- To emphasize the role of urologists in managing these complications.
Main Methods:
- Review of current literature on COVID-19's impact on the genitourinary system.
- Analysis of reported urological symptoms and complications.
- Discussion of the role of ACE2 receptors in SARS-CoV-2 infection.
Main Results:
- COVID-19 can lead to acute kidney injury (AKI), testicular structural changes, impaired spermatogenesis, and hypogonadism.
- SARS-CoV-2 detection in urine and semen is rare, but urological symptoms are common.
- Androgen inhibition did not prove effective in preventing or treating COVID-19.
Conclusions:
- COVID-19 poses a risk of significant damage to the genitourinary tract.
- Urologists are essential in diagnosing and managing COVID-19-related genitourinary complications.
- Further research is needed to understand and mitigate long-term effects.
Abstract:
On 11 March 2020, the WHO declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic and COVID-19 emerged as one of the biggest challenges in public health and economy in the twenty-first century. The respiratory tract has been the centre of attention, but COVID-19-associated complications affecting the genitourinary tract are reported frequently, raising concerns about possible long-term damage in these organs. The angiotensin-converting enzyme 2 (ACE2) receptor, which has a central role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion, is highly expressed in the genitourinary tract, indicating that these organs could be at a high risk of cell damage. The detection of SARS-CoV-2 in urine and semen is very rare; however, COVID-19 can manifest through urological symptoms and complications, including acute kidney injury (AKI), which is associated with poor survival, severe structural changes in testes and impairment of spermatogenesis, and hormonal imbalances (mostly secondary hypogonadism). The effect of altered total testosterone levels or androgen deprivation therapy on survival of patients with COVID-19 was intensively debated at the beginning of the pandemic; however, androgen inhibition did not show any effect in preventing or treating COVID-19 in a clinical study. Thus, urologists have a crucial role in detecting and managing damage of the genitourinary tract caused by COVID-19.
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