Assessment of Overactive Bladder Symptoms in Deconditioned Patients Recovering From Post-Acute COVID-19 Syndrome.
Journal of Urology
INTRODUCTION AND OBJECTIVE:
SARS-CoV2 infection that results in coronavirus disease (COVID-19) manifests in multiple organ systems, including the respiratory, the heart and circulatory as well as the gastrointestinal systems. However, little is known about its impact on the genitourinary system. Preliminary reports indicate some patients may develop a so-called “post-acute COVID-19 Syndrome or Long COVID,” in which they experience persistent symptoms after recovering from their initial illness. The objective of the present investigation was to determine such impact on bladder function in patients who were treated for COVID-19 in the acute care hospital and then transferred to inpatient rehabilitation at the Rehabilitation Institute of Michigan for long-term care of deconditioning secondary to the viral illness.
We used AUA Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to screen all recovering COVID-19 patients at the Rehabilitation Institute of Michigan from 6/1/2020 to 12/31/2020. Primary outcomes include patient responses to 5 symptom and 4 quality-of-life questions (QOL). We reported median symptom scores, as well as quality-of-life scores, based on new or worsening urinary symptoms stratified by sex.
We identified 25 patients with de novo and 20 patients with worsening OAB symptoms. In our cohort, 20 patients with pre-existing OAB experienced no change in their symptoms. In patients with new onset OAB symptoms, the median symptom score was 17. Patients with worsening OAB symptoms had a median pre-COVID-19 symptom score of 8 which was exacerbated post-COVID-19 as indicated by the median symptom score of 19. The median total QOL score for both men and women was 19. In patients with worsening OAB, median pre-COVID-19 QOL score was 9 compared to median post-COVID-19 QOL score of 19. Median age was 66 (range 41-82).
In a population of deconditioned patient recovering from the COVID-19 infection at an inpatient rehabilitation facility we noted that OAB symptoms either occurred de novo or worsened, and QOL scores declined in the majority of patients (45 out of 65). Urological manifestation may be an important part of Post-Acute COVID-19 Syndrome that may impact quality of life and hinders full recovery from COVID-19. More research is needed to raise awareness of urologic impact of Long COVID and to further delineate the pathophysiological mechanisms of de novo or worsening urological symptoms in Post-Acute COVID-19 Syndrome.
Khaliq F, Wills M, Dhar N, Bitar A, Dhar S, Komnenov D, et al. Assessment of overactive bladder symptoms in deconditioned patients recovering from post-acute COVID-19 syndrome. J Urol. 2021 Sep;206(suppl 3):e18-e19.