Evaluation of Treatment Results of Urolithiasis Complications Among Covid-19 Patients

Abstract

Objective. To study the peculiarities of diagnostics and treatment of urolithiasis complications among patients with new coronavirus infection COVID-19. Methods. The prospective cohort study evaluated the treatment outcomes of patients (n=146). The first group (n=30) included patients treated in infectious diseases hospital with a complicated urinary calculi disease and a new coronavirus infection COVID-19, the second group (n=116) included patients treated in the urological department of multidisciplinary non-infectious hospital due to complicated urinary tract stone disease who were not infected by new coronavirus infection COVID-19. As for COVID 19 diagnostics, patients of the first group were done PCR tests that were positive in 19 (63,3%) cases, and thoracic cavity computer tomography scanning (upon admission the percentage of pulmonary tissue involvement varied since 5% up to 90%). Results. Among the patients of the first group, elderly people prevailed (61+15 years) and there were more women among them (66%). The characteristic features of complicated urinary calculi disease in patients with COVID-19 are the prevalence of infectious and inflammatory complications (50%) and a combination of several complications of urolithiasis (40%). Among peculiarities of treatment, patients of the first group in 6.6% of cases underwent the lumbotomy with open nephrostomy, due to the spread of secondary suppurative process over the retroperitoneal space. According to the Clavien-Dindo scale, in the first group of patients the incidence of complications after surgery was 40%, in the second - 13.8%. Mortality rate in the first group reached 30%, in the second - 0.9%. The duration of hospital treatment among patients of the first group reached 21 (5-39) days, among patients of the second group - 8 (1-56) days. Conclusion. The specificity of the course associated with significant morbidity and mortality require further optimization therapeutic approachesto achieve success in patientswith complications of urolithiasis duringCOVID-19outbreak. What this paper adds The peculiarities of diagnostics and treatment of urinary tract stone disease complications among patients with new coronavirus infection COVID-19 have been studied. It is shown that the typical differences of patients with complicated urolithiasis and new coronavirus infection COVID-19 are elderly and old age, being a female, prevalence of pyelonephritis and paranephritis in clinical presentations, and presence of several combined complications of the urolithiasis. Mortality rate upon complicated urolithiasis and new coronavirus infection COVID-19 since the pandemic onset has reached 30% that demands optimization of treatment approaches in patients of this group.