eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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abstract:
Clinical research

Changing patterns of urologic emergency visits and admissions during the COVID-19 pandemic: a retrospective, multicenter, nationwide study

Pawel Rajwa
1
,
Mikolaj Przydacz
2
,
Wojciech Krajewski
3
,
Blazej Kuffel
4
,
Piotr Zapala
5
,
Aleksandra Krzywon
6
,
Alexander J. Cortez
6
,
Bartosz Dybowski
7
,
Remigiusz Stamirowski
8
,
Marcin Jarzemski
9
,
Rafal B. Drobot
10
,
Pawel Stelmach
11, 12
,
Krystyna Mlynarek
13
,
Mateusz Marcinek
14
,
Maciej Przudzik
15
,
Wiktor Krawczyk
8
,
Jakub Ryszawy
1
,
Dominik Choragwicki
2
,
Lukasz Zapala
5
,
Marcin Lipa
10
,
Michal Pozniak
4
,
Dawid Janczak
11, 12
,
Szymon Słomian
13
,
Jan Łaszkiewicz
3
,
Marcel Nowak
14
,
Marcin Miszczyk
16
,
Marek Roslan
15
,
Michał Tkocz
14
,
Romuald Zdrojowy
3
,
Andrzej Potyka
13
,
Tomasz Szydełko
11, 12
,
Tomasz Drewa
4
,
Piotr Jarzemski
9
,
Piotr Radziszewski
5
,
Marcin Slojewski
8
,
Artur Antoniewicz
10
,
Andrzej Paradysz
1
,
Piotr L. Chlosta
2

1.
Department of Urology, Medical University of Silesia, Zabrze, Poland
2.
Department of Urology, Jagiellonian University Medical College, Krakow, Poland
3.
Department of Urology and Urological Oncology, Wroclaw Medical University, Wroclaw, Poland
4.
Department of General and Oncological Urology, 1st University Hospital, Nicolaus Copernicus University, Bydgoszcz, Poland
5.
Department of General, Oncological and Functional Oncology, Medical University of Warsaw, Warsaw, Poland
6.
Department of Biostatistics and Bioinformatics, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
7.
Department of Urology, Roefler Memorial Hospital, Pruszkow, Poland
8.
Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
9.
Department of Urology, Jan Biziel University Hospital in Bydgoszcz, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
10.
Department of Urology and Urological Oncology, Multidisciplinary Hospital in Warsaw-Miedzylesie, Warsaw, Poland
11.
Clinical Department of Urology, 4th Clinical Military Hospital, Wroclaw, Poland
12.
Division of Oncology and Palliative Care, Faculty of Health Sciences, Wroclaw Medical University, Poland
13.
Urological Ward, Independent Public Health Care Unit, Voivodeship Specialised Hospital No. 3, Rybnik, Poland
14.
Department of Urology, FMS in Katowice, Medical University of Silesia, Katowice, Poland
15.
University of Warmia and Mazury, Faculty of Medicine, Department of Urology, Olsztyn, Poland
16.
Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
Arch Med Sci
Online publish date: 2020/08/25
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Introduction
We aimed to examine the change in the number and severity of visits to the emergency departments (EDs) and subsequent admissions for urgent urologic conditions in the early stage of the coronavirus disease 2019 (COVID-19) pandemic in Poland.

Material and methods
We evaluated data from 13 urologic centers in Poland and compared the number of visits to the EDs and subsequent admissions before and after the advent of COVID-19 in 2020, and before and after the escalating national restrictions. Furthermore, data on types of urologic complaints, crucial laboratory parameters, and post-admission procedures were analyzed.

Results
In total 1,696 and 2,187 urologic visits (22.45% decrease) and 387 and 439 urologic urgent admissions (11.85% decrease) were reported in given periods in 2020 and 2019, respectively. The year-over-year difference in daily mean visits was clear (36.1 vs. 46.5; p < 0.001). Declines were seen in all complaints but device malfunction. In 2020 daily mean visits and admissions decreased from 40.9 and 9.6 before lockdowns to 30.9 (p < 0.001) and 6.9 (p = 0.001) after severe restrictions, respectively. There was a trend towards more negative laboratory parameter profiles in 2020, with patients who visited the EDs after severe restrictions having twice as high median levels of C-reactive protein (15.39 vs. 7.84, p = 0.03).

Conclusions
The observed declines in ED visits and admissions were apparent with the significant effect of national lockdowns. Our results indicate that some of the patients requiring urgent medical help did not appear at the ED or came later than they would have done before the pandemic, presenting with more severe complaints.

keywords:

coronavirus, COVID-19, urology, emergency, admissions, visits

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