Herzberg Haim, Savin Ziv, Lasmanovich Rinat, Marom Ron, Ben-David Reuben, Mano Roy, Yossepowitch Ofer, Sofer Mario
Department of Urology, Tel-Aviv Sourasky Medical Center Sackler School of Medicine, Tel Aviv University Tel Aviv Israel.
BJUI Compass. 2022 Mar 13;3(4):298-303. doi: 10.1002/bco2.145. eCollection 2022 Jul.
To assess the influence of COVID-19-imposed life changes on presentation and outcomes of patients with obstructing urinary stones complicated by infection.
All patients presenting with obstructing urinary stones and infection 1 year before the pandemic (March 2019 to February 2020; = 66) and 1 year since its onset (March 2020 to February 2021; = 45) were enrolled. Demographics, clinical presentation, laboratory panel, stone characteristics and outcomes were compared between groups. Univariate and multivariate logistic regression models were performed for analysis.
The COVID-19 period was characterised by younger patients, female predominance, higher temperature at presentation and more bilateral obstructing stones ( < 0.05). The admission rate to intensive care units was double that of the pre-pandemic period, whereas time between diagnosis and treatment was similar. The univariate analysis revealed higher rates of severe sepsis (odds ratio [OR] = 3, = 0.01), systemic inflammatory response syndrome (SIRS) ≥ 2 (OR = 2.9, = 0.01) and risk, injury, failure, loss of kidney function and end-stage kidney (RIFLE) criteria ≥ 1 (OR = 2.2, = 0.04) in the pandemic period group. The multivariate analyses revealed the COVID-19 period as being the sole variable associated with severe sepsis (OR = 3.1, = 0.02), SIRS ≥ 2 (OR = 3.8, = 0.005) and RIFLE ≥ 1 (OR = 2.6, = 0.05).
The pandemic period was characterised by a worse clinical state at presentation of patients with obstructing urinary stones complicated by infection, probably reflecting delay in arrival to emergency services.
评估新冠疫情导致的生活变化对合并感染的梗阻性尿路结石患者的就诊情况及治疗结果的影响。
纳入疫情爆发前1年（2019年3月至2020年2月；n = 66）以及疫情爆发后1年（2020年3月至2021年2月；n = 45）期间所有合并感染的梗阻性尿路结石患者。比较两组患者的人口统计学特征、临床表现、实验室检查指标、结石特征及治疗结果。采用单因素和多因素逻辑回归模型进行分析。
新冠疫情期间患者的特点为年龄较轻、女性居多、就诊时体温较高以及双侧梗阻性结石较多（P < 0.05）。重症监护病房的收治率是疫情前的两倍，而诊断至治疗的时间相似。单因素分析显示，疫情期间组严重脓毒症发生率更高（比值比[OR] = 3，P = 0.01）、全身炎症反应综合征（SIRS）≥2发生率更高（OR = 2.9，P = 0.01）以及肾功能风险、损伤、衰竭、丧失及终末期肾病（RIFLE）标准≥1发生率更高（OR = 2.2，P = 0.04）。多因素分析显示，新冠疫情期间是与严重脓毒症（OR = 3.1，P = 0.02）、SIRS≥2（OR = 3.8，P = 0.005）及RIFLE≥1（OR = 2.6，P = 0.05）相关的唯一变量。
疫情期间，合并感染的梗阻性尿路结石患者就诊时临床状态更差，这可能反映了患者前往急诊就诊的延迟。
