COVID-19 akut ürolityazisi nasýl etkiledi? Bir iç Anadolu deneyimi

AMAÇ: COVID-19 pandemisi, COVID-19 dýþý þikayetlerle acil servisten týbbi yardým isteyen hasta sayýsýný deðiþtirmiþ, farklý týbbi ve cerrahi durumlarýn ertelenmiþ baþvurularýna neden olmuþtur Akut üriner taþ hastalýðý da bu durumlardan biridir ve COVID-19’un acil servise geliþine etkisi açýsýndan araþtýrýlmasý gerekmektedir.
GEREÇ VE YÖNTEM: Bu gözlemsel, retrospektif ve tek merkezli çalýþmada, acil serviste olasý akut ürolitiyazis için istenen her abdominopelvik bil-gisayarlý tomografiyi COVID-19 pandemisinden önceki ve sonraki 1 yýlý ele alarak taradýk. Uygulanan abdominopelvik bilgisayarlý tomografi sayýsýný ve üriner taþ pozitifliðini doðrulayan sayýyý belirledik. Hastalarýn cinsiyetini, yaþýný, taþýn yerini ve taþ boyutunu kaydettik. Ayrýca C-reaktif protein, lökosit sayýsý ve kreatinin deðerlerini kaydettik ve hastalarýn ne kadar süredir aðrý çektiðini, müdahaleye kadar geçen süreyi ve her vaka için seçilen tedavi metodunu not ettik.
BULGULAR: Yapýlan toplam abdominopelvik bilgisayarlý tomografi sayýsý 1089 idi. Bunlardan 517’si pandemi öncesi dönemde, 572’si pandemi sü-recindeydi. Pandemi öncesi ve sýrasýnda taþ pozitifliði sýrasýyla 363 (%70.2) ve 379 (%66.2) idi (p=0.643). Kadýnlarýn COVID-19 dönemindeki oraný (%37.2), pandemi öncesi dönemden (%54.3) anlamlý derecede düþüktü (p=0.013). Pandemi öncesi ve pandemi süreci gruplarýndaki üreter taþlarýnýn medyan boyutu sýrasýyla 4.8 mm ve 3.9 mm idi ve anlamlý bir fark göstermedi (p=0.197). Pandemi öncesinde ve sýrasýnda gruplar arasýnda taþýn yerleri, kan parametreleri, aðrý süresi, tedavi seçenekleri ve müdahale süresi açýsýndan anlamlý bir fark görülmedi.
TARTIÞMA: COVID-19 pandemisi, acil servise akut üreterik kolik vakalarý ile baþvuran daha az veya daha ciddi hasta ile sonuçlanmadý.

How did COVID-19 affect acute urolithiasis? An inner Anatolian experience

BACKGROUND: The COVID-19 pandemic has changed the number of patients seeking medical help from the emergency service (ES) with non-COVID complaints, consequencing in postponed presentations of different surgical and medical situations. Acute urinary stone disease is one of these situations and needs to be investigated in terms of the effect of COVID-19 on its presentation to the ES.
METHODS: In this observational, retrospective, and single-center study, we scanned each abdominopelvic computed tomography requested in ES for possible acute urolithiasis during 1 year before and after the outbreak of COVID-19. We searched to state the number of abdominopelvic computed tomographies applied and the number of ratifying urinary stone positivity. We enrolled patients’ gender, age, stone location, and stone size. We also recorded C-reactive protein, leukocyte count, and creatinine and noted how long the patients suffering from pain, the duration until the intervention, and the management option selected for each case.
RESULTS: Total number of abdominopelvic computed tomographies performed was 1089. Of these, 517 were pre-pandemic and 572 were peri-pandemic. The number of pre and peri-pandemic stone-positive scans were, respectively, 363 (70.2%) and 379 (66.2%) (P=0.643). The females’ percentage in the COVID-19 period (37.2%) was significantly lower than in the pre-pandemic period (54.3%) (P=0.013). The median size of ureter stones of the pre and peri-pandemic groups were, respectively, 4.8 mm and 3.9 mm depicting no significant difference (P=0.197). No significant difference was sighted between the pre and peri-pandemic groups concerning stone locations, blood parameters, painful duration, treatment options, and time to intervention.
CONCLUSION: The COVID-19 pandemic resulted in neither sicker nor fewer patients suffering from acute ureteric colic in the ES.