INTRODUCTION AND OBJECTIVE: In a pandemic of a new coronavirus infection (COVID-19), most clinical centres in Moscow have been reorganized for the treatment of covid patients. In this abstract, we report our experience in providing emergency urological care for COVID-19 patients in specialized urology department. METHODS: Since December 2020 to February 2021, our urological department has been reorganized into a specialized department for patients with COVID-19 pneumonia, and urgent care for patients with urological emergencies: acute urinary retention (AUR), renal colic, hematuria, and pyelonephritis. 48 patients underwent surgery in this period of time (36 males and 12 females). RESULTS: The mean age of the patients was 61 years (±7.4 years). The average hospital stay was 7 days (±3,4 days). 33 patients (68.75%) had grade 1-2 viral pneumonia, 15 patients (31.25%) had CT grade 3-4. The average C-reactive protein was 69 mg/L (±12.1 mg/L). The average white blood cell count was 12.1x109/L (±5,3 x 109/L). The average blood D-dimer was 918 ng/ml (±129 ng/ml). The average blood fibrinogen constituted 5.6 g/l (±1.2 g/l). The mean oxygen saturation value at the time of surgery averaged 84% (±8%). 28 patients (58.3%) needed oxygen supplementation. All patients were on anticoagulant therapy and 29 patients received IL-6 inhibitors. Suprapubic cystostomy was placed in 17 patients with AUR. Cystoscopy followed by endoscopic hemostasis was performed in 3 patients with haematuria. Ureteral stent and nephrostomy tube placement were performed in 19 and 9 patients with renal colic and pyelonephritis. All surgeries were performed under local or intravenous anaesthesia according to EAU recommendations. Haematuria was the most common postoperative complication - 10.4% (5 patients). Urinary tract infections reported by 2 patients. Progression of pneumonia, and respiratory insufficiency requiring patients transfer to the ICU, was noted in 16.7% (8 patients). 3 patients died. The mean age of deceased patients was 74 years all of them had comorbid pathology, severe grade 4 pneumonia, and were hypoxic at the time of surgery. The cause of death in 2 patients was respiratory distress syndrome and pulmonary embolism. CONCLUSIONS: Despite the data on high postoperative mortality among patients with COVID-19, the results of our study revealed a fairly acceptable level of postoperative complications and mortality. The main risk factors for death were hypoxia and the severity of pneumonia. Compliance with the recommendations for providing medical care to patients with COVID-19 developed by the EAU has a crucial role in management patients of this kind.
Urologic emergency care during the COVID-19 pandemic