1
|
Gomes CM, Hisano M, Souza JD, Henriques JVT, de Bessa J, Moromizato J, Bosi T, Mazoni R, Gismondi J, Camargo B, Sammour ZM, Bruschini H, Battistella LR, Nahas WC. Lower Urinary Tract Symptoms in a prospective cohort of COVID-19 survivors. Int Braz J Urol 2024; 50:287-295. [PMID: 38498685 DOI: 10.1590/s1677-5538.ibju.2023.0546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/07/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE To analyze the prevalence of lower urinary tract symptoms (LUTS) in patients who survived moderate and severe forms of COVID-19 and the risk factors for LUTS six months after hospitalization. MATERIALS AND METHODS In this prospective cohort study, patients were evaluated six months after hospitalization due to COVID-19. LUTS were assessed using the International Prostate Symptom Score. General health was assessed through the Hospital Anxiety and Depression Scale and the EQ5D-L5 scale, which evaluates mobility, ability to perform daily activities, pain and discomfort and completed a self-perception health evaluation. RESULTS Of 255 participants, 54.1% were men and the median age was 57.3 [44.3 - 66.6] years. Pre-existing comorbidities included diabetes (35.7%), hypertension (54.5%), obesity (30.2%) and physical inactivity (65.5%). One hundred and twenty-four patients (48.6%) had a hospital stay >15 days, 181 (71.0%) were admitted to an ICU and 124 (48.6%) needed mechanical ventilation. Median IPSS was 6 [3-11] and did not differ between genders. Moderate to severe LUTS affected 108 (42.4%) patients (40.6% men and 44.4% women; p=0.610). Nocturia (58.4%) and frequency (45.9%) were the most prevalent symptoms and urgency was the only symptom that affected men (29.0%) and women (44.4%) differently (p=0.013). LUTS impacted the quality of life of 60 (23.5%) patients with women more severely affected (p=0.004). Diabetes, hypertension, and self-perception of worse general health were associated with LUTS. CONCLUSIONS LUTS are highly prevalent and bothersome six months after hospitalization due to COVID-19. Assessment of LUTS may help ensure appropriate diagnosis and treatment in these patients.
Collapse
Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Marcelo Hisano
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Julia D Souza
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | | | - Jose de Bessa
- Departamento de Cirurgia, Universidade Estadual de Feira de Santana, Bahia, Brasil
| | - Julyana Moromizato
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Thulio Bosi
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Rachel Mazoni
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - João Gismondi
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Bruno Camargo
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Zein M Sammour
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Homero Bruschini
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Linamara R Battistella
- Instituto de Medicina Física e de Reabilitação, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - William C Nahas
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| |
Collapse
|
2
|
Gomes CM, de Souza JD, Anzolch KMJ, Henriques JVT, Nogueira L, Pimentel E, Fernandes RDC, Canalini AF, de Bessa J. Is it safe to resume large scale in-person medical meetings? Int Braz J Urol 2022; 48:857-863. [PMID: 35594330 PMCID: PMC9388187 DOI: 10.1590/s1677-5538.ibju.2022.0210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Cristiano M. Gomes
- Faculdade de Medicina da Universidade de São PauloDivisão de Clínica UrológicaSão PauloBrasilDivisão de Clínica Urológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Julia Duarte de Souza
- Faculdade de Medicina da Universidade de São PauloDivisão de Clínica UrológicaSão PauloBrasilDivisão de Clínica Urológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil,Julia Duarte de Souza, MD, Divisao de Clinica Urologica Hospital das Clinicas da Universidade de São Paulo Avenida Dr. Eneas de Carvalho Aguiar, 255 Sala 710F, 7 Andar São Paulo, SP, 05403-000, Brasil. Telephone: +55 11 2661-8080 Fax: +55 11 3064-7013 E-mail:
| | - Karin M. J. Anzolch
- Hospital Moinhos de VentoDepartamento de UrologiaPorto AlegreRSBrasilDepartamento de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - João Victor T. Henriques
- Faculdade de Medicina da Universidade de São PauloDivisão de Clínica UrológicaSão PauloBrasilDivisão de Clínica Urológica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Lucas Nogueira
- Universidade Federal de Minas GeraisHospital das ClínicasDepartamento de UrologiaBelo HorizonteMGBrasilDepartamento de Urologia do Hospital das Clínicas, Universidade Federal de Minas Gerais – UFMG, Belo Horizonte, MG, Brasil
| | - Eduardo Pimentel
- Hospital de Base do Distrito FederalDepartamento de UrologiaBrasíliaDFBrasilDepartamento de Urologia, Hospital de Base do Distrito Federal, Brasília, DF, Brasil
| | - Roni de C. Fernandes
- Santa Casa de São PauloFaculdade de MedicinaSão PauloSPBrasilFaculdade de Medicina, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Alfredo F. Canalini
- Universidade do Rio de JaneiroDepartamento de UrologiaRio de JaneiroRJBrasilDepartamento de Urologia, Universidade do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - José de Bessa
- Universidade de Feira de SantanaDepartamento de CirurgiaFeira de SantanaBABrasilDepartamento de Cirurgia, Universidade de Feira de Santana, Feira de Santana, BA, Brasil
| |
Collapse
|
3
|
Prezotti JA, Henriques JVT, Favorito LA, Canalini AF, Machado MG, Brandão TBV, Barbosa AMV, Moromizato JKM, Anzolch KMJ, Fernandes RDC, Rodrigues FRA, Bellucci CHS, Silva CS, Pompeo ACL, de Bessa J, Gomes CM. Impact of COVID-19 on education, health and lifestyle behaviour of Brazilian urology residents. Int Braz J Urol 2021; 47:753-776. [PMID: 33848067 PMCID: PMC8321480 DOI: 10.1590/s1677-5538.ibju.2021.99.09] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 01/03/2023] Open
Abstract
Objectives: To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents. Materials and Methods: A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents’ concerns, and access to personal protective equipment (PPE). Results: Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 – 7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P< 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents’ concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues. Conclusions: COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents’ losses.
Collapse
Affiliation(s)
- José Antonio Prezotti
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - João Victor T Henriques
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Luciano A Favorito
- Unidade de Pesquisa Urogenital, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Alfredo F Canalini
- Disciplina de Urologia, Universidade do Estado do Rio de Janeiro - UERJ, Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Marcos G Machado
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Thulio B V Brandão
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Akemi M V Barbosa
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Julyana K M Moromizato
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Karin M J Anzolch
- Serviço de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | - Roni de C Fernandes
- Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | | | - Carlos H S Bellucci
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| | - Caroline S Silva
- Departamento de Cirurgia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | | | - Jose de Bessa
- Departamento de Cirurgia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - Cristiano M Gomes
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, São Paulo, SP, Brasil
| |
Collapse
|
4
|
Gomes CM, Favorito LA, Henriques JVT, Canalini AF, Anzolch KMJ, de Carvalho Fernandes R, Bellucci CHS, Silva CS, Wroclawski ML, Pompeo ACL, de Bessa J. Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists. Int Braz J Urol 2020; 46:1042-1071. [PMID: 32539253 PMCID: PMC7527096 DOI: 10.1590/s1677-5538.ibju.2020.99.15] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. MATERIALS AND METHODS A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. RESULTS Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 - 4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). CONCLUSIONS COVID-19 produced massive disturbances in Brazilian urologists' practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians' income, health and personal lives. These findings are probably applicable to other medical specialties.
Collapse
Affiliation(s)
- Cristiano M Gomes
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Luciano A Favorito
- Unidade de Pesquisa Urogenital, Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - João Victor T Henriques
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Alfredo F Canalini
- Divisão de Urologia, Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil
| | - Karin M J Anzolch
- Departamento de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil
| | | | - Carlos H S Bellucci
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
| | - Caroline S Silva
- Departamento de Saúde Pública e Epidemiologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| | - Marcelo L Wroclawski
- Departamento de Urologia, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil
- Departamento de Urologia, Beneficência Portuguesa de São Paulo, São Paulo, SP, Brasil
| | | | - José de Bessa
- Departamento de Saúde Pública e Epidemiologia, Universidade Estadual de Feira de Santana, Feira de Santana, BA, Brasil
| |
Collapse
|