Estimating the Impact of COVID-19 on Urology: Data from a Large Nationwide Cohort

Lewicki, Patrick; Basourakos, Spyridon P.; Awamlh, Bashir Al Hussein Al; Wu, Xian; Hu, Jim C.; Schlegel, Peter N.; Shoag, Jonathan E.

The impact of the coronavirus disease 2019 (COVID-19) pandemic on urology worldwide has been the subject of frequent speculation, but population-level estimates on changes in urology care are sparsely reported. Here, we use newly released data from a large USA-based cohort to provide further insight into the impact of the pandemic on our field. For a final cohort of 900,900 patient encounters in 418 hospitals, we describe an approximately 20% decrease in urology-specific emergency room (ER) visits (19.4%, 95% confidence interval [CI] 17.4–21.5%), admissions to a urology service (19.3%, 95% CI 13.7–24.9%), and ambulatory urology surgeries (22.9%, 95% CI 13.2–32.6%) during March 2020 relative to baseline. On linear regression, region was the sole predictor of decrease in volume, reflecting the heterogeneous spread of the SARS-CoV-2 virus within the USA. Selected higher-acuity ER presentations, such as obstructing kidney stones and “acute scrotum”, appeared to be preserved relative to lower-acuity presentations, such as nonobstructing stones, hematuria, and urinary retention. These data create context for changes observed by individual urology practices and shed light on triage patterns during natural disasters. Patient summary The coronavirus disease 2019 (COVID-19) pandemic decreased the amount of urology care provided in the USA by approximately 20% during March 2020. Patients with complaints potentially requiring imaging tests or surgery seemed to come to the emergency room at nearly normal levels.