Impact of COVID-19 pandemic on patients with obstructing urinary stones complicated by infection

Area of Science:

• Urology
• Infectious Diseases
• Public Health

Background:

• COVID-19 pandemic significantly altered daily life and healthcare access.
• Obstructing urinary stones complicated by infection represent a critical clinical scenario.

Purpose of the Study:

• To evaluate the impact of COVID-19-related life changes on the presentation and outcomes of patients with infected obstructing urinary stones.
• To compare clinical characteristics and outcomes between pre-pandemic and pandemic periods.

Main Methods:

• Retrospective analysis of patients with obstructing urinary stones and infection.
• Comparison of two groups: 1 year before (March 2019-February 2020) and 1 year after the pandemic onset (March 2020-February 2021).
• Statistical analysis using univariate and multivariate logistic regression models.

Main Results:

• Pandemic period patients were younger, predominantly female, with higher presentation temperatures and more bilateral stones.
• Higher intensive care unit admission rates (doubled) and increased rates of severe sepsis, systemic inflammatory response syndrome (SIRS) ≥2, and acute kidney injury (RIFLE criteria ≥1) were observed during the pandemic.
• Multivariate analysis identified the COVID-19 period as the sole significant factor associated with severe sepsis, SIRS ≥2, and RIFLE criteria ≥1.

Conclusions:

• The COVID-19 pandemic period was associated with a more severe clinical presentation in patients with infected obstructing urinary stones.
• This likely reflects delayed presentation to emergency services due to pandemic-related life changes.
• Urgent urological care for infected stones remains critical, even during public health crises.