Has the COVID-19 influenced the patient presentations and therapeutic options for urolithiasis?

Objective: To identify the influence of COVID-19 on the patient presentations and therapeutic options of urolithiasis resort to hospital during the first year of the pandemic. Methods: : A systematic literature review of Pubmed, Embase, Web of Science, Ovid EMBR, and Cochrane library was performed from Jan 2020 to Dec 2021. The PRISMA criteria were followed for article selection. The pooled analysis such as age, gender, stone characters, time of symptom to a hospital visit, therapeutic methods, and length of hospital stay was calculated using the random-effects model. A subgroup analysis of fewer than 45 days since the epidemic was conducted. Results: : Twelve retrospective studies were included, and the total number of patients was 4116 patients before versus 3409 during the COVID-19. The patient decreased by 17.2% during COVID. Even with significant heterogeneity in many aspects of comparison, the sensitivity analysis showed the robustness of the results. The patients' age, gender, comorbidity, stone size, and stone location stayed unchanged. But the delay in hospital visits was statistically significant and supported by the elevated white blood count and level of hydronephrosis. Regarding therapeutic options, the rate of medical expulsive therapy & observation, shock wave lithotripsy, and definitive therapy (ureteroscopy lithotripsy, percutaneous nephrolithiasis, and bladder lithotripsy) remained unchanged. There was no death report within the included studies before or during the COVID period. The subgroup analysis of < 45 days shows the likewise results. Conclusion: The impact of the COVID-19 pandemic on patients mainly was canceling or postponing the hospital visit. However, the highest level of emergency cases was similar. Meanwhile, the essential treatment of urolithiasis remained. These demonstrate the limited influence of COVID on urolithiasis during the first year of the pandemic.