Impact of COVID-19 Pandemic on Emergency Department Referrals with Urologic Complaints; a Retrospective Cross-Sectional Study

Medical and surgical priorities were dramatically changed during the COVID-19 pandemic. Thisstudy aimed to evaluate the impact of this pandemic on presentation to emergency department (ED) with uro-logic complaint.

This cross-sectional study was conducted at a tertiary urology referral center inTehran, Iran. The data of all ED admissions were collected and the frequency of admissions with urologic com-plain and their outcomes were compared between two 90-day periods (before and during COVID-19 era).Re-sults:480 ED admissions were studied. The number of patients visiting the ED with urologic complaint duringCOVID-19 era was significantly lower than the same period in the pre-COVID-19 period (125 vs. 355 admissions;p = 0.01). The mean hospitalization days for patients in the pre-COVID-19 period were significantly higher (5.6± 4.4 vs. 3.2 ± 4.2 days; p <0.001). The most common patient complaints before and during COVID-19 periodwere flank pain (32.7%) and gross hematuria (32.8%), respectively. The number of patients discharged againstmedical advice in the COVID-19 period was significantly higher than before (22 (17.6%) vs. 10(2.8%); p < 0.001).The number of patients who developed severe complications was significantly higher in the COVID-19 periodthan in the pre-COVID-19 period (p = 0.001).

During the COVID-19 pandemic we were faced withdecreasing frequency of admission with urologic complaint, change in the pattern of referrals, decrease in theduration of hospitalization, increase in the number of patients discharged against medical advice, and increasein the number of cases with irreversible urologic complications or complications requiring surgery due to de-ferred treatment.