Patients with Covid-19 develop new OAB symptoms

American Urological Association 2021 meeting, 10-13 September 2021

Priscilla Lynch presents a round-up of the latest overactive bladder research presented at the 2021 American Urological Association meeting.

Patients with Covid-19 reported experiencing severe genitourinary symptoms during infection, and new or worsening overactive bladder (OAB) symptoms after recovery, according to recent findings from two studies presented at the American Urological Association 2021 (AUA) meeting.

Prof Michael B. Chancellor, Professor of urology at Oakland University Beaumont School of Medicine, and colleagues conducted a study to determine whether genitourinary symptoms were associated with pro-inflammatory cytokines in the urine of patients with Covid-19. The analysis included 53 patients with normal renal function who were hospitalised for Covid-19 and 12 asymptomatic control patients. The researchers assessed patients with an AUA Urology Care Foundation OAB Assessment Tool to determine their urinary symptoms based on a scale of 0 to 25, with increasing scores representing increasing severity. They also collected urine samples from patients, which were then tested for SARS-CoV-2 and pro-inflammatory cytokines. Patients’ median age was 64.5 years.

The median total OAB symptom score among patients with Covid-19 was 18, with a range from four to 21. Quality-of-life scores ranged from eight to 24, with a median of 19; higher scores related to better quality-of-life.
Patients with symptoms of Covid-19-associated cystitis experienced increased urinary urgency, frequency, nocturia and pain as well as worsening quality-of-life, according to Prof Chancellor.

he researchers found that most patients with Covid-19 did not have the virus in their urine. However, levels of inflammatory cytokines, including interleukin-6, IL-10, GRO/CXCL and C-reactive protein, were significantly increased in patients with Covid-19. These cytokines may correlate with severity and duration of Covid-19 infection, he said.

“In conclusion, our study shows that Covid-19 can have de novo and severe genitourinary symptoms that are highly bothersome,” Prof Chancellor said.

In a separate study, Dr Nivedita Dhar, a urologist at the DMC Medical Group in Michigan, and colleagues assessed OAB symptoms after patients recovered from Covid-19. Using the same OAB Assessment Tool, the researchers collected symptom and quality-of-life scores among patients who were recovering from Covid-19 in a hospital between May 22, 2020, and December 31, 2020. The median age of patients was 64.5 years and the median length of stay in the hospital was 10 days.

Dr Dhar and colleagues identified 350 patients with new or worsening OAB symptoms. In patients with a new onset of OAB symptoms, the median symptom score was 18. Individuals with worsening OAB symptoms had a median score of eight before developing Covid-19 and a median score of 19 after recovery, according to the data. Meanwhile, the median quality-of-life score among all patients was 19. In those with worsening OAB, the median quality-of-life score before Covid-19 was nine compared with a score of 20 after recovery.
The study concluded that the exacerbation of OAB symptoms following Covid-19 “was evident by increases in symptom severity scores and deteriorating quality-of-life”.