Impact of COVID-19 and Vaccination on Lower Urinary Tract Symptoms: Insights From a Prospective Cohort Study

To evaluate the prevalence, clinical course, and risk factors of lower urinary tract symptoms (LUTS) in patients hospitalized with COVID-19, and to assess associations with comorbidities, disease severity, and vaccination status.

We conducted a prospective cohort study of adult patients hospitalized with confirmed COVID-19, who were not in intensive care at the time of enrollment, between July 2021 and March 2022. LUTS were assessed using the International Prostate Symptom Score (IPSS), International Consultation on Incontinence Questionnaire Overactive Bladder (ICIQ-OAB), and ICIQ-Urinary Incontinence Short Form (ICIQ-UI SF) questionnaires during hospitalization and at one and 3 months post-discharge. Moderate to severe LUTS were defined as an IPSS > 7. Overactive bladder symptoms (OAB symptoms) were defined as an ICIQ-OAB Score ≥ 3 plus urgency and/or urgency urinary incontinence (UUI). Associations with sex, comorbidities, COVID-19 severity, and vaccination status were analyzed using multivariable logistic regression.

Among 168 patients (55.4% male, median age 58 years), 31.0% had moderate to severe LUTS during hospitalization, with storage symptoms predominating. Urgency was present in 21.4% of the cohort, and 36.7% met the criteria for OAB symptoms. Urinary incontinence (UI) affected 34.5%, being more frequent among women. At 3 months, moderate to severe LUTS declined to 21.9%, and both OAB symptoms and UI also decreased significantly. No associations were found between LUTS and comorbidities or disease severity. Fully vaccinated patients had higher odds of moderate to severe LUTS during hospitalization (adjusted OR 10.56, 95% CI 4.13-26.9), particularly those vaccinated with inactivated virus vaccines (BBIBP-CorV).

LUTS are prevalent in the acute phase of COVID-19, especially among women, but tend to improve within 3 months. Unexpectedly, full vaccination-especially with inactivated virus vaccines-was associated with increased odds of moderate to severe LUTS during hospitalization. Further studies are warranted to explore the underlying mechanisms and long-term implications.

This study was not registered at ClinicalTrials.gov, as it is an observational study with no clinical intervention.