Patients with COVID-19 develop new, worsening overactive bladder symptoms

Patients with COVID-19 reported experiencing severe genitourinary symptoms during infection, and new or worsening overactive bladder symptoms after recovery, according to recent findings from two studies.

The data were presented at the American Urological Association meeting.

During infection

Michael B. Chancellor, MD, a 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 hospitalized for COVID-19 and 12 asymptomatic control patients. The researchers assessed patients with an AUA Urology Care Foundation Overactive Bladder (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 Chancellor.

The 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, Chancellor said.

“In conclusion, our study shows that COVID-19 can have de novo and severe genitourinary symptoms that are highly bothersome,” Chancellor said during a prerecorded presentation.

The symptoms experienced by patients with COVID-19 fall under the umbrella of OAB, Suzette E, Sutherland, MD, director of female urology at the University of Washington and moderator of the presentation, noted.

After recovery

In a separate study, Nivedita Dhar, MD, 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 Dec. 31, 2020. The median age of patients was 64.5 years and the median length of stay in the hospital was 10 days.

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 8 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 9 compared with a score of 20 after recovery.

Dhar and colleagues concluded that the exacerbation of OAB symptoms following COVID-19 “was evident by increases in symptom severity scores and deteriorating quality of life.” The pathophysiological mechanisms remain unknown, they added.

Additional research is needed to assess the potential role of COVID-19-associated cystitis in long COVID, Chancellor said.

References:

Chancellor MB, et al. MP29-15: COVID-19 associated cystitis (CAC): increased urinary symptoms and biomarkers of inflammation in urine in patients with acute COVID-19. Presented at: American Urological Association meeting; Sept. 10, 2021 (virtual meeting).

Chen W, et al. MP63-02: New or worsening overactive bladder symptoms after recovery from COVID-19. Presented at: American Urological Association meeting; Sept. 10, 2021 (virtual meeting).