Studies Correlate Overactive Bladder Onset After A COVID-19 Diagnosis

BALTIMORE, Sept. 10, 2021 /PRNewswire/ -- The burden of COVID-19 can affect not only a patient's respiratory health, but their bladder health as well. Two new studies being presented this year at the American Urological Association's 2021 Annual Meeting demonstrate the relationship between COVID-19 and the onset of or worsening of symptoms of Overactive Bladder (OAB). The following study was presented during a virtual press session, which was moderated by Dr. Suzette Sutherland. The recording of this session is now available for viewing.

Watch Briefing

Abstracts Include:

Publication # MP29-15
COVID-19 Associated Cystitis (CAC): Increased Urinary symptoms and biomarkers of Inflammation in Urine in Patients with Acute COVID-19

Emerging evidence suggests the bladder is one of many organs targeted by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS­CoV-2), which contributes significantly to COVID-19 morbidity and leads to organ-specific complications. Hear from the first U.S. group to identify severe and bothersome de novo genitourinary symptoms in patients with confirmed SARS-CoV-2 infection, termed COVID-19 Associate Cystitis (CAC). The study sought to determine if this was associated with pro-inflammatory cytokines in the urine of patients.

Key findings:

• COVID-19 patients reported severe de novo genitourinary symptoms, most notably an increase in urgency, frequency, and nocturia.
• SARS-CoV-2 infection results in increased expression of proinflammatory biomarkers in the urine.
• The variance between individuals may reflect the severity and duration of their disease, and/or the presence of comorbidities. This data supports that COVID-19 patients, especially those with CAC, have increased inflammatory cytokines in the urine.

Publication # MP63-02
New or Worsening Overactive Bladder Symptoms After Recovery from COVID-19

Since the emergence of COVID-19 in December 2019, it has become evident that additional to the respiratory impairment, many other organ systems are targeted by the disease-causing SARS-CoV2 virus. Due to the paucity of data regarding genitourinary symptoms in COVID-19, this study set out to investigate the disease manifestation(s) in bladder function.

Key findings:

• Results showed an increase in the number of patients suffering from new or worsening OAB symptoms after their recovery from COVID-19, which necessitated hospitalization
• Exacerbation of symptoms post-COVID-19 in patients with existing OAB was evident by increases in symptom severity scores and deteriorating QOL. At present, the pathophysiological mechanisms of de nova or worsening OAB symptoms after recovery from COVID-19 are unknown.

"COVID-19 affects multiple systems throughout the human body," Dr. Sutherland said. "These two studies highlight that it's crucial we understand how the virus affects urinary tract tissues, particularly in patients with OAB, to be able to strategize effective treatment options."

Full abstracts can be viewed online:
https://www.auajournals.org/doi/10.1097/JU.0000000000002026.15
https://www.auajournals.org/doi/10.1097/JU.0000000000002103.02

About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is a leading advocate for the specialty of urology, and has more than 22,000 members throughout the world. The AUA is a premier urologic association, providing invaluable support to the urologic community as it pursues its mission of fostering the highest standards of urologic care through education, research and the formulation of health policy.

Publication Number: MP29-15

Title: COVID-19 Associated Cystitis (CAC): increased urinary symptoms and biomarkers of inflammation in urine in patients with acute COVID-19

INTRODUCTION AND OBJECTIVES: Emerging evidence suggests that the bladder is one of many organs targeted by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS­CoV-2), which contributes significantly to Coronavirus Disease 2019 (COVID-19) morbidity and leads to organ-specific complications. We were the first U.S. group to identify severe and bothersome de novo genitourinary symptoms in patients with confirmed SARS-CoV-2 infection, termed COVID-19 Associate Cystitis (CAC). We then sought to determine if this was associated with pro-inflammatory cytokines in the urine of patients.

METHODS: With IRB approval, hospital discharged COVID-19 patients with normal renal function (N=53) and asymptomatic controls (N=12) completed an AUA Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to determine their current urinary symptoms (score of O to 25, increasing severity) and provided a urine sample. Urine samples were tested for SARS-CoV-2 using PCR, CRP by ELISA, and pro-inflammatory cytokines using Luminex assays following manufacturer's instructions.

RESULTS: The median total OAB symptom score in both men and women with COVID-19 was 18 (range 4-21). The median total QOL score for both men and women with COVID-19 was 19 (range 8-24). Median age was 64.5 (range 47-82). Symptoms of CAC include increased urinary frequency, urgency, nocturia, and pain or pressure upon voiding. These symptoms were not due to urinary tract infection, acute renal injury, prostatitis, or urinary retention. These symptoms have caused worsening QOL in CAC patients, and nocturia the most bothersome symptom. The majority of COVID-19 patients did not have virus in their urine. The levels of GRO/CXCL-1, IL-6, IP-10, and CRP were significantly increased in urine samples from COVID-19 patients compared to controls.

CONCLUSIONS: COVID-19 patients reported severe de novo genitourinary symptoms, most notably an increase in urgency, frequency, and nocturia. SARS-CoV-2 infection results in increased expression of proinflammatory biomarkers in the urine. The variance between individuals may reflect the severity and duration of their disease, and/or the presence of comorbidities. This data supports that COVID-19 patients, especially those with CAC, have increased inflammatory cytokines in the urine.

AUTHORS: Michael B. Chancellor*, Royal Oak, MI, Melissa Wills, Ryan Timar, Detroit, MI, Sarah N. Bartolone, Royal Oak, MI, Nevedita Dhar, Sorabh Dhar, Dragana Komnenov, Detroit, MI, Laura E. Lamb, Royal Oak, MI

Publication Number: MP63-02

Title: New or Worsening Overactive Bladder Symptoms After Recovery from COVID-19

INTRODUCTION AND OBJECTIVES: Since the emergence of the coronavirus disease

(COVID-19) in December 2019, it has become evident that additional to the respirafory impairment, many other organ systems are targeted by the disease-causing SARS-CoV2 virus. Due to the paucity of data regarding genitourinary symptoms in COVID-19, we set out to investigate the disease manifestation(s) in bladder function. We identified recovered COVID-19 patients presenting with new or worsening overactive bladder symptoms, known as COVID-19 Associated Cystitis (CAC).

METHODS: We used AUA Urology Care Foundation Overactive Bladder (OAB) Assessment Tool to screen COVID-19 recovered patients at our urban-located institution from 5/22/2020 to 12/31/2020. Primary outcomes include patient responses to 5 symptom and 4 quality-of­life questions (QOL). We reported median symptom scores, as well as quality-of-life scores, based on new or worsening urinary symptoms stratified by sex.

RESULTS: We identified 350 patients with de novo or worsening OAB symptoms. In patients with new onset OAB symptoms, the median symptom score was 18. Patients with worsening OAB symptoms had a median pre-COVID-19 symptom score of 8 which was exacerbated post-COVID-19 as indicated by the median symptom score of 19. The median total QOL score for both men and women was 19. In patients with worsening OAB, median pre-COVID-19 QOL score was 9 compared to median post-COVID-19 QOL score of 20. Median age was 64.5 (range 47-82). Median length of stay was 10 days (range 5-30).

CONCLUSIONS: Here we report survey-based results of patients suffering from new or worsening OAB symptoms after recovery from COVID-19 which necessitated hospitalization. The total median symptom score for patients with de nova OAB was 18 and QOL score was19, irrespective of sex, indicating moderate to severe OAB. Exacerbation of symptoms post-COVID-19 in patients with existing OAB was evident by increases in symptom severity scores and deteriorating QOL. At present, the pathophysiological mechanisms of de nova or worsening OAB symptoms after recovery from COVID-19 are unknown.

AUTHORS: Wen Chen*, Dragana Komnenov, Ryan Timar, Melissa Wills, Sorabh Dhar, Nivedita Dhar, Detroit, MI

SOURCE American Urological Association

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