Department of Urology, University Medical Center, Johannes Gutenberg University, Mainz, Germany,
Department of Urology, University Hospital Luebeck, Luebeck, Germany.
Urol Int. 2021;105(3-4):199-205. doi: 10.1159/000513458. Epub 2021 Jan 6.
The coronavirus disease 2019 (COVID-19) pandemic is disrupting urology health-care worldwide. Reduced emergency room visits resulting in adverse outcomes have most recently been reported in pediatrics and cardiology. We aimed to compare patients with emergency room visits for pyelonephritis in 2019 (pre-COVID-19 era) and within the first wave of pandemic in 2020 (COVID-19 era) with regard to the number of visits and severe adverse disease outcomes.
We performed a retrospective multicentre study comparing characteristics and outcomes of patients with pyelonephritis, excluding patients with hydronephrosis due to stone disease, in 10 urology departments in Germany during a 1-month time frame in March and April in each 2019 and 2020.
The number of emergency room visits for pyelonephritis in the COVID-19 era was lower (44 patients, 37.0%) than in the pre-COVID-19 era (76 patients, 63.0%), reduction rate: 42.1% (p = 0.003). Severe adverse disease outcome was more frequent in the COVID-19 era (9/44 patients, 20.5%) than in the pre-COVID-19 era (5/76 patients, 6.6%, p = 0.046). In detail, 7 versus 3 patients needed monitoring (15.9 vs. 3.9%), 2 versus no patients needed intensive-care treatment (4.5 vs. 0%), 2 versus no patients needed drain placement (4.5 vs. 0%), 2 versus no patients had a nephrectomy (4.5 vs. 0%), and 2 versus 1 patient died (4.5 vs. 1.3%).
This report of collateral damage during CO-VID-19 showed that emergency room visits were decreased, and severe adverse disease outcomes were increased for patients with pyelonephritis in the COVID-19 era. Health authorities should set up information campaign programs actively encouraging patients to utilize emergency room services in case of severe symptoms specifically during the actual second wave of pandemic.
2019 年冠状病毒病（COVID-19）大流行正在扰乱全球的泌尿科医疗保健。最近在儿科和心脏病学中报告了由于急诊室就诊减少而导致的不良后果。我们旨在比较 2019 年（COVID-19 大流行前）和 2020 年大流行的第一波（COVID-19 时代）中因肾盂肾炎就诊的患者，比较急诊就诊次数和严重不良疾病结局。
我们进行了一项回顾性多中心研究，比较了德国 10 个泌尿科部门在 2019 年 3 月和 4 月的一个月内因肾盂肾炎就诊的患者的特征和结局，排除了因结石病引起的肾盂积水患者。
COVID-19 时代因肾盂肾炎就诊的急诊次数较低（44 例，37.0％），而 COVID-19 大流行前就诊次数较高（76 例，63.0％），降低率为 42.1％（p = 0.003）。COVID-19 时代严重不良疾病结局更为常见（9/44 例，20.5％），而 COVID-19 大流行前更为少见（5/76 例，6.6％，p = 0.046）。具体而言，7 例患者需要监测（15.9％比 3.9％），2 例患者需要重症监护治疗（4.5％比 0％），2 例患者需要引流（4.5％比 0％），2 例患者需要肾切除术（4.5％比 0％），2 例患者死亡（4.5％比 1.3％）。
这项关于 COVID-19 期间附带损害的报告表明，因肾盂肾炎就诊的急诊次数减少，而 COVID-19 时代的严重不良疾病结局增加。卫生当局应积极开展宣传活动，鼓励患者在出现严重症状时特别是在大流行的实际第二波期间利用急诊服务。
