COVID-19: The impact on urolithiasis treatment in Brazil

Abstract

Introduction: It has been more than a year since the fi rst case of Covid-19 was diagnosed in Brazil, and its most problematic feature is the oversaturation of the healthcare system capacity. Urolithiasis is a disease that requires timely and appropriate management. The present study aimed to evaluate the impact of the pandemic in hospital admissions for urolithiasis in the Brazilian public healthcare system. Materials and Methods: In this cross-sectional study, hospital admissions were obtained from the Brazilian Public Health Information system. All hospital admissions associated with urolithiasis diagnosis (ICD-10 N20) between March 2017 and February 2021 were analyzed.Results: During the COVID-19 outbreak, there was a signifi cant decrease in hospital admissions (p<0.0001). More than 20.000 patients probably did not have the opportunity to undergo their surgeries. The impact of the COVID-19 outbreak on women's admissions was signifi cantly more intense than for men, reducing from 48.91% to 48.36% of the total (p=0.0281). The extremes of age seemed to be more affected, with patients younger than 20 years and older than 60 years having a signifi cant reduction in access to hospital services (p=0.033). Conclusions: In conclusion, we have noticed a considerable reduction in overall admissions for the treatment of urolithiasis in the Brazilian public healthcare system during the fi rst year of the Covid-19 pandemic. Women and individuals older than 60 years were especially affected. In contrast, we noted a rise in urgent procedures, comparing with the average of the corresponding period of the three previous years. Recovery plans will be needed while returning to activities to handle the impounded surgical volume.

Impact of COVID‐19 on the management and outcomes of ureteric stones in the UK: a multicentre retrospective study

“…Other studies have reported a decrease in urological presentations during the COVID‐19 pandemic [22–25]. We therefore predicted that during the pandemic patients with ureteric colic would have delayed presenting to hospital and therefore have been a more unwell cohort.…”

Recommendations for prostate cancer diagnosis and treatment during COVID-19 outbreak were not followed in Brazil

“…Several studies have demonstrated a decrease in non-COVID-related hospital admissions, including reductions in elective procedures (1)(2)(3)(4)(5). In Germany, non-COVID overall inpatient admissions decreased by 35% after the lockdown announcement, with even admissions for critical care conditions such as cancer treatment significantly reduced (4).…”

“…It demands populational screening with multiple clinic visits, prostate biopsies, imaging for staging, and finally, the treatment that comprehends surgery, radiotherapy, androgen deprivation therapy (ADT), and chemotherapy (9). Some studies have demonstrated the impact of the COVID-19 pandemic on hospital admissions in chronic conditions and non-covid related emergencies (2)(3)(4)(5). In Brazil, many health care institutions had their non-urgent procedures and elective surgeries suspended for months to concentrate economic and human resources to respond to the COVID-19 outbreak waves (10).…”

Impact of COVID-19 on the management and outcomes of ureteric stones in the UK: a multicentre retrospective study

“…Other studies have reported a decrease in urological presentations during the COVID-19 pandemic 21–24 We therefore predicted that during the pandemic patients with ureteric colic would have delayed presenting to hospital and therefore have been a more unwell cohort. However, in our data, rates of AKI and active infection were lower in the pandemic patient cohort suggesting that these patients did not delay their presentation long enough to impact their clinical condition.…”