Shivakumar Natesh, Nantha Kumar Dhanya, Joshi Hrishi
Department of Urology, University Hospital of Wales, Cardiff, United Kingdom.
School of Medicine, Cardiff University, Cardiff, United Kingdom.
J Endourol. 2022 Sep;36(9):1255-1264. doi: 10.1089/end.2022.0167. Epub 2022 May 23.
It is acknowledged that the COVID-19 pandemic has had a major impact on health care services around the globe with possible worse outcomes. It has resulted in stretch of resources with canceled or delayed procedures. Patients with urinary calculi have also suffered the negative impact. This systematic review aims to assess the impact of the early COVID-19 pandemic on the presentation and management of urinary calculi around the globe. We reviewed the impact of early COVID-19 on the clinically important aspects of stone disease using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched Medline, Embase, and Central databases using themes of COVID-19 OR Sars-Cov-2 OR pandemic OR coronavirus AND kidney stone, urinary calculi, urolithiasis, and similar allied terms. Inclusion criteria were studies with data on both pre- and COVID-19 period covering one or more of eight clinical domains. Our search returned 231 studies, after removal of duplicates, of which 18 studies were included for analysis. The number of patients presenting to hospital declined by 21%-70% at the beginning of the pandemic, whereas majority of studies reported increased associated complications. There are mixed reports in terms of delay to presentation and use of conservative management. There was a consistent trend toward reduction in elective procedures with wide variations (shockwave lithotripsy 38%-98%, percutaneous nephrolithotomy 94%-100%, and ureteroscopy 8%-98%). There was a trend toward increased nephrostomy insertion with the onset of the pandemic. This review demonstrated the differences in the number of patients presenting to hospital, complication rates, and management of urinary calculi, including surgical interventions, with the onset of the COVID-19 pandemic. It offers baseline global information that would help understand the impact of early pandemic, variations in practices, and be useful for future comparisons.
人们认识到，新冠疫情对全球医疗服务产生了重大影响，可能导致更糟糕的结果。它导致资源紧张，手术被取消或推迟。尿石症患者也受到了负面影响。本系统评价旨在评估新冠疫情早期对全球尿石症诊治的影响。我们使用系统评价和Meta分析的首选报告项目（PRISMA）方法，回顾了新冠疫情早期对结石病临床重要方面的影响。我们在Medline、Embase和Central数据库中搜索，使用的主题为新冠病毒、严重急性呼吸综合征冠状病毒2、大流行、冠状病毒以及肾结石、尿石症、尿路结石症和类似相关术语。纳入标准是涵盖八个临床领域中一个或多个领域的、有新冠疫情前后数据的研究。我们的搜索返回了231项研究，去除重复项后，其中18项研究被纳入分析。在疫情开始时，入院患者数量下降了21%-70%，而大多数研究报告相关并发症增加。关于就诊延迟和保守治疗的使用，报告不一。择期手术有持续减少的趋势，降幅差异很大（冲击波碎石术为38%-98%，经皮肾镜取石术为94%-100%，输尿管镜检查为8%-98%）。随着疫情的开始，肾造瘘术的实施有增加的趋势。本综述表明，随着新冠疫情的开始，尿石症患者的数量、并发症发生率以及包括手术干预在内的尿石症治疗存在差异。它提供了全球基线信息，有助于了解疫情早期的影响、实践差异，并对未来的比较有用。
