Selçuk ERDEM, Faruk ÖZCAN, Ömer SARILAR, Faruk ÖZGÖR, Mehmet Çağlar ÇAKICI, Ayberk İPLİKÇİ, Gökhan ATIŞ, Asıf YILDIRIM, Alper ÖTÜNÇTEMUR, Mustafa Zafer TEMİZ, Ahmet Yaser MÜSLÜMANOĞLU, Eyüp Veli KÜÇÜK, Alper Kerem AKSOY, Murat ÖZER, İsmail ULUS, Enes DEĞİRMENCİ, Reşat AYDIN

The clinical impact of the COVID-19 pandemic on daily urological practice: first 3-month multicenter results from İstanbul

Background/aim: The aim of this paper was to determine the general tendencies of urology patients and effect of COVID-19 pandemic on daily urological practice at tertiary centers located in the most affected area in Turkey. Materials and methods: We retrospectively analyzed the data of 39,677 patients (group 1) that applied to 6 different large-volume tertiary centers in İstanbul for outpatient consultation, surgery, or other procedures in the 3-month period between March 16 and June 14, 2020. The distribution of the number of patients who applied to subspecialty sections of urology outpatient clinics and inpatient services were recorded by weeks. That data was compared to data obtained from 145,247 patients that applied to the same centers in the same period of the previous year (group 2). The reflection of worldwide and Turkish COVID-19 case distribution on the daily urological practice was analyzed. Results: There was a decrease in the number of patients in all subspecialty sections the in group 1 compared to group 2; however, there was a significant proportional increase in urooncology and general urology admissions. A decrease of approximately 75% was observed in the total number of surgeries (p < 0.001). We detected a negative correlation between the numbers of admission to all outpatient clinics and COVID-19 cases or deaths in Turkey (p < 0.05). The same negative correlation was present for all surgical procedures and consultations (p < 0.05). The multivariate linear regression analysis revealed that the number of cases in Turkey, and the number of deaths worldwide affect the number of outpatient clinic admissions (R2 = 0.38, p = 0.028) and urological surgery (R2 = 0.33, p = 0.020) in Turkey negatively. Conclusion: This novel pandemic has implications even for urology practice. Urological surgical procedures were more affected by COVID-19-related deaths in Turkey and worldwide. Outpatient admissions and urological surgeries decreased significantly by increasing COVID-19 case numbers in Turkey and worldwide deaths.Key words: COVID-19 virus infection, outpatients, pandemics, urology, urologic surgical procedure

PDF

___

1. Wang D, Hu B, Hu C, Zhu F, Liu X et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirusinfected pneumonia in Wuhan, China. The Journal of the American Medical Association 2020; 323: 1061-1069. doi: 10.1001/jama.2020.1585
2. Thornton J. Covid-19: A&E visits in England fall by 25% in week after lockdown. British Medical Journal 2020; 6;369:m1401. doi: 10.1136/bmj.m1401
3. McLean RC, Young J, Musbahi A, Lee JX, Hidayat H et al. A single-centre observational cohort study to evaluate volume and severity of emergency general surgery admissions during the COVID-19 pandemic: Is there a “lockdown” effect? International Journal of Surgery 2020 12: S1743- 9191(20)30674-9. doi: 10.1016/j.ijsu.2020.09.011
4. Barten DG, Latten GHP, van Osch FHM. Reduced emergency department utilization during the early phase of the COVID-19 pandemic: viral fear or lockdown effect? Disaster Medicine and Public Health Preparedness 2020; 12: 1-4. doi: 10.1017/ dmp.2020.303
5. Soytaş M, Boz MY, Güzelburç V, Çalık G, Horuz R et al. Comparison of before and after COVID-19 urology practices of a pandemic hospital. Turkish Journal of Urology 2020; 46(6): 474-480. doi: 10.5152/tud.2020.20230
6. Diokno AC, Devries JM. The impact of COVID-19 on urologic practice, medical education, and training. International Urology and Nephrology 2020; 52(7): 1195-1198. doi: 10.1007/ s11255-020-02511-0
7. Gravas S, Bolton D, Gomez R, Klotz L, Kulkarni S et al. Impact of COVID-19 on urology practice: a global perspective and snapshot analysis. Journal of Clinical Medicine 2020; 9: 1730. doi: 10.3390/jcm9061730
8. Borchert A, Baumgarten L, Dalela D, Jamil M, Budzyn J et al. Managing urology consultations during COVID-19 pandemic: application of a structured care pathway. Urology 2020; 141: 7-11. doi: 10.1016/j.urology.2020.04.059
9. Bozkurt O, Sen V, Irer B, Sagnak L, Onal B et al. Study group of the Society of Urological Surgery. Nation-wide analysis of the impact of Covid-19 pandemic on daily urology practice in Turkey. International Journal of Clinical Practice 2020 30: e13735. doi: 10.1111/ijcp.13735 (Epub ahead of print).
10. Ficarra V, Novara G, Abrate A, Bartoletti R, Crestani A et al. Research urology network (RUN). Urology practice during the COVID-19 pandemic. Minerva Urologica a Nefrologica 2020; 72: 369-375. doi: 10.23736/S0393-2249.20.03846-1
11. Ribal MJ, Cornford P, Briganti A, Knoll T, Gravas S et al. European Association of Urology guidelines office rapid reaction group: an organisation-wide collaborative effort to adapt the European Association of Urology guidelines recommendations to the coronavirus disease 2019 Era. European Urology 2020; 78: 21-28. doi: 10.1016/j.eururo.2020.04.056
12. Tyagi V, Sharma AK, Bhandari M. Urological implications of SARS CoV-19. Canadian Journal of Urology 2020; 27: 10205- 10212. PMID: 32544042
13. Baum A, Schwartz MD. Admissions to veterans affairs hospitals for emergency conditions during the COVID-19 pandemic [published online ahead of print, 2020 Jun 5]. The Journal of the American Medical Association 2020; 324: 96-99. doi: 10.1001/jama.2020.9972
14. Temiz MZ, Yürük E, Kandıralı E, Semerciöz A, Müslümanoğlu AY. The urological practice and contribution to the general health system of the EBU accredited urology clinic during the first month of COVID-19 pandemic: An analysis from a tertiary center declared as a national COVID-19 pandemic hospital in Turkey. Turkish Journal of Urology 2020; 9. doi: 10.5152/tud.2020.20362 (Epub ahead of print)
15. Patel S, Douglas-Moore J. A reflection on an adapted approach from face-to-face to telephone consultations in our urology outpatient department during the COVID-19 pandemic - a pathway for change to future practice? British Journal of Urology International. 2020; 126(3): 339-341. doi: 10.1111/ bju.15119
16. Motterle G, Morlacco A, Iafrate M, Bianco M, Federa G et al. The impact of COVID-19 pandemic on urological emergencies: a single-center experience. World Journal of Urology 2020; 23: 1-5. doi: 10.1007/s00345-020-03264-2
17. Wang H, Zhang L. Risk of COVID-19 for patients with cancer. Lancet Oncology 2020; 21:e181. doi: 10.1016/S1470- 2045(20)30149-2
18. Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China. The Journal of the American Medical Association Oncology. 2020; 6: 1108-1110. doi: 10.1001/jamaoncol.2020.0980
19. Proietti S, Gaboardi F, Giusti G. endourological stone management in the era of the COVID-19. European Urology 2020; 78: 131-133. doi: 10.1016/j.eururo.2020.03.042
20. Gul M, Kaynar M, Yildiz M, Batur AF, Akand M et al. The increased risk of complicated ureteral stones in the era of COVID-19 pandemic. J Endourol 2020; 34(8): 882-886. doi: 10.1089/end.2020.0658