The effect of COVID-19 outbreak on urological procedures for urinary stones: data from three high-volumes centers in China.

ABSTRACT

China has been the first country to be affected by the COVID-19 outbreak. The pandemic resulted in significant disruption of Health Care Services worldwide, and this effect on treatments for urinary stones is currently unclear. This is the first retrospective study involving three tertiary referral centers for urolithiasis across China. We evaluated surgical volumes and peri-operative outcomes of procedures delivered for upper urinary tract stones. We compared trimester prior to restrictions for COVID-19 (October 1st, 2019 to December 31st, 2019, period A), during restrictions (February 1st, 2020 to March 31st, 2020, period B), and afterword (April 1st, 2020 to June 31st, 2020, period C). A total of 2,543 procedures have been carried out. We observed a loss of 743 cases during period B (-29.2%) and 201 during period C (-7.9%). Percutaneous surgery showed the worst reduction, with 507 mini-PCNLs delivered in period A, 168 in period B (-60.8%), and 389 (-18.3%) in period C (p = 0.001). A worst trend was shown for standard PCNLs with 84 procedures carried out in period A, 5 in period B (-95.2%), and 9 (-89.2%) in period C (p = 0.001). Retrograde surgery also decreased, from 420 cases in period A to 190 cases in period B (-54.8%). An increment was however seen in period C when 468 cases have been carried out (+ 11.4%, p = 0.008). In term of SFRs, a difference was noticed for RIRSs, being 69.2%, 80.5%, and 69.3% during three periods (p = 0.045) and semirigid ureteroscopies (90.3%, 97.1%, and 84.8%, p = 0.013). Charlson's Comorbidity Score could not show any difference between groups as well as no differences in term of post-operative complications have been noticed.