Urology in the Time of Coronavirus: Reduced Access to Urgent and Emergent Urological Care during the Coronavirus Disease 2019 Outbreak in Italy

Porreca, Angelo; Colicchia, Michele; D'Agostino, Daniele; Amenta, Michele; Corsaro, Alfio; Zaramella, Stefano; Zegna, Luisa; Gallo, Fabrizio; Schenone, Maurizio; Bozzini, Giorgio; Calori, Alberto; Pastore, Antonio L.; Al Salhi, Yazan; Sciorio, Carmine; Spirito, Lorenzo; Varca, Virginia; Marenghi, Carlo; Greco, Francesco; Altieri, Vincenzo M.; Verze, Paolo; Barba, Ciro; Antonelli, Alessandro; Cerruto, Maria A.; Falabella, Roberto; Di Bello, Silvana; Leonardo, Costantino; Tufano, Antonio; Volpe, Alessandro; Umari, Paolo; Parma, Paolo; Nidini, Mattia; Pini, Giovannalberto; Borghesi, Marco; Terrone, Carlo; Cacciamani, Giovanni E.; Sighinolfi, Maria C.; Busetto, Gian Maria; Wennberg, Alexandra M.; Finocchiaro, Marinella; Falsaperla, Mario; Oderda, Marco; Ceruti, Carlo; Rocco, Bernardo; Schiavina, Riccardo; Bianchi, Lorenzo; Mari, Andrea; Di Maida, Fabrizio; Dalpiaz, Orietta; Celia, Antonio; Pirozzi, Marco; Bove, Pierluigi; Iacovelli, Valerio; Cafarelli, Angelo; Cindolo, Luca; Ferrari, Giovanni; Gatti, Lorenzo; Pirola, Giacomo; Annino, Filippo; Pucci, Luigi; Romagnoli, Daniele; Artibani, Walter; Minervini, Andrea

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy. MATERIALS AND METHODS: A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes. RESULTS: Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05). CONCLUSION: In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions.