This single-centre, retrospective, observational and comparative study was exempted from further review by the Institutional Review Board (Bioethical Committee) of the Pomeranian Medical University, Szczecin, Poland, and was conducted in accordance with the regulations set forth by the Declaration of Helsinki. Patients included in this study routinely consented to participate in the study, specifically to allow the use of their anonymised treatment data for scientific purposes. We analysed consecutively admitted patients who were treated in the Department of Urology and Urological Oncology in Szczecin for an acute episode of urolithiasis during the first peak of SARS-CoV-2 infection in Poland (October–December 2020; Study group A). We compared them with patients admitted between October–December, 2019 (pre-COVID-19 era; Control group). In addition, to observe a changing pattern in the admission of patients with acute renal colic during the pandemic, we analysed the medical records of patients admitted consecutively during the second peak of COVID-19 cases in Poland (February–April 2021; Study group B). The selection of the analysed periods was based on the daily incidence of new SARS-CoV-2 cases in Poland. During the first peak of infection, the highest daily number of new cases was up to 30,000, whereas the highest recorded daily incidence during the second peak of the COVID-19 pandemic in Poland was 35,000 cases [10 (link)]. Throughout the pandemic, urological healthcare in Szczecin was significantly reorganised. The department that served as the focus of the present study was the only one to deal with emergency urological patients who did not suffer from COVID-19. Other urological departments in Szczecin were closed, and only one urological department was dedicated to hospitalising SARS-CoV-2-positive patients requiring emergency urological care.
For the present study, we only included patients who presented with symptoms of renal colic and required subsequent admission to the urological department. Indications for hospital admission included renal colic of a solitary kidney, bilateral renal colic, kidney injury, infected renal colic, intractable pain or nausea, and urinary extravasation. Before hospitalisation, each patient was examined by a urologist. Additionally, laboratory tests and urinary tract ultrasonography were performed to establish hydronephrosis. Finally, unenhanced computed tomography (CT) was performed to identify the location and size of the stones and to provide information regarding other potential aetiologies of pain. CT was also used to guide further management of the condition.
Data extracted from the medical records included age, gender, sex, body mass index (BMI), duration of symptoms, presence of fever, inflammatory markers, glomerular filtration rate (GFR), urinalysis, and urine and blood cultures. In addition, variables related to the presence of deposits on unenhanced CT, such as the size, location, and degree of hydronephrosis, were collected. Depending on the clinical presentation and images acquired, patients were qualified for further treatment: medical expulsive therapy (MET), urinary drainage (nephrostomy or double J stent implantation) with delayed definitive stone removal after the infection was cleared, or emergency removal of the deposit. Finally, all three analysed periods were compared to determine changing patterns in the clinical presentation of patients and management options chosen for acute episodes of urolithiasis after the reorganisation of emergency urological care due to the COVID-19 pandemic.
For the present study, we only included patients who presented with symptoms of renal colic and required subsequent admission to the urological department. Indications for hospital admission included renal colic of a solitary kidney, bilateral renal colic, kidney injury, infected renal colic, intractable pain or nausea, and urinary extravasation. Before hospitalisation, each patient was examined by a urologist. Additionally, laboratory tests and urinary tract ultrasonography were performed to establish hydronephrosis. Finally, unenhanced computed tomography (CT) was performed to identify the location and size of the stones and to provide information regarding other potential aetiologies of pain. CT was also used to guide further management of the condition.
Data extracted from the medical records included age, gender, sex, body mass index (BMI), duration of symptoms, presence of fever, inflammatory markers, glomerular filtration rate (GFR), urinalysis, and urine and blood cultures. In addition, variables related to the presence of deposits on unenhanced CT, such as the size, location, and degree of hydronephrosis, were collected. Depending on the clinical presentation and images acquired, patients were qualified for further treatment: medical expulsive therapy (MET), urinary drainage (nephrostomy or double J stent implantation) with delayed definitive stone removal after the infection was cleared, or emergency removal of the deposit. Finally, all three analysed periods were compared to determine changing patterns in the clinical presentation of patients and management options chosen for acute episodes of urolithiasis after the reorganisation of emergency urological care due to the COVID-19 pandemic.
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