Infectious Disease

Patients with COVID-19 develop new, worsening symptoms of overactive bladder

September 15, 2021

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Chancellor MB et al. MP29-15: COVID-19 Associated Cystitis (CAC): Elevated Urinary Symptoms and Biomarkers of Inflammation in Urine in Patients with Acute COVID-19. Presented at: American Urological Association Meeting; 09/10/2021 (virtual meeting).

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Patients with COVID-19 reported severe genitourinary symptoms during infection and new or worsening symptoms of overactive bladder after recovery, according to recent results from two studies.

The data were presented at the American Urological Association meeting.

Chen W. et al. MP63-02: New or Worsening Symptoms of Overactive Bladder After Recovery from COVID-19. Presented at: American Urological Association Meeting; 09/10/2021 (virtual meeting).

During the infection

Michael B. Federal Chancellor, MD, a professor of urology at Oakland University’s Beaumont School of Medicine, and colleagues conducted a study to determine whether urogenital symptoms were linked to pro-inflammatory cytokines in the urine of patients with COVID-19. The analysis included 53 patients with normal kidney function hospitalized for COVID-19 and 12 asymptomatic control patients. Researchers rated patients using an AUA Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to determine their urinary symptoms based on a scale of 0-25, with increasing scores indicating increasing severity. They also collected urine samples from patients, which were then tested for SARS-CoV-2 and pro-inflammatory cytokines. The mean age of the patients was 64.5 years.

The median overall OAB symptom score in patients with COVID-19 was 18, with a range of four to 21. Quality of life ranged from eight to 24, with a median of 19; higher values ​​associated with a better quality of life. According to the Chancellor, patients with symptoms of COVID-19-associated cystitis suffered from an increased urge to urinate, more frequent urination, nocturia and pain as well as a deterioration in quality of life.

The researchers found that most patients with COVID-19 did not have the virus in their urine. However, levels of inflammatory cytokines, including interleukin-6, IL-10, GRO / CXCL, and C-reactive protein, were significantly increased in patients with COVID-19. These cytokines can correlate with the severity and duration of the COVID-19 infection, said Chancellor.

“In summary, our study shows that COVID-19 can have de novo and severe urogenital symptoms that are very disturbing,” said Chancellor during a recorded presentation.

The symptoms of patients with COVID-19 fall under the umbrella of OAB. Suzette E, Sutherland, MD, Director of Female Urology at the University of Washington and moderator of the presentation, noted.

After recovery

In a separate study Nivedita Dhar, MD, a urologist with DMC Medical Group in Michigan and colleagues assessed OAB symptoms after patients recovered from COVID-19. Using the same OAB assessment tool, the researchers collected symptom and quality of life scores from patients who recovered from COVID-19 in a hospital between May 22, 2020 and December 31, 2020. The mean age of the patients was 64.5 years and the median length of stay in the hospital was 10 days.

Dhar and colleagues identified 350 patients with new or worsening OAB symptoms. For patients with recurrence of OAB symptoms, the median symptom score was 18. People with worsening OAB symptoms had a median of 8 before developing COVID-19 and a median of 19 after recovery, according to the data. Meanwhile, the median quality of life score for all patients was 19. In the patients with worsening OAB, the median quality of life score before COVID-19 was 9 compared to a score of 20 after recovery.

Dhar and colleagues concluded that the worsening of OAB symptoms after COVID-19 “was evident from an increase in symptom severity and a deterioration in quality of life”. The pathophysiological mechanisms are still unknown, they added.

Additional research is needed to evaluate the potential role of COVID-19-associated cystitis in long-term COVID, said Chancellor.

References:

Chancellor MB et al. MP29-15: COVID-19 Associated Cystitis (CAC): Increased Urinary Symptoms and Biomarkers of Inflammation in Urine in Patients with Acute COVID-19. Presented at: American Urological Association Meeting; 09/10/2021 (virtual meeting).

Chen W. et al. MP63-02: New or Worsening Symptoms of Overactive Bladder After Recovery from COVID-19. Presented at: American Urological Association Meeting; 09/10/2021 (virtual meeting).

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American Urological Society

American Urological Society

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