High Levels of Incidental COVID-19 Infection in Emergency Urology Admissions: A Propensity Score-Matched Real World Data Analysis across Surgical Specialties
Abstract
:1. Introduction
2. Methodology
2.1. Study Design
2.2. Patients
2.3. Outcomes
2.4. Statistical Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Sohrabi, C.; Alsafi, Z.; O’Neill, N.; Khan, M.; Kerwan, A.; Al-Jabir, A.; Iosifidis, C.; Agha, R. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int. J. Surg. 2020, 76, 71–76. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. WHO Coronavirus (COVID-19) Dashboard. Available online: https://covid19.who.int (accessed on 28 May 2024).
- Gupta, A.; Madhavan, M.V.; Sehgal, K.; Nair, N.; Mahajan, S.; Sehrawat, T.S.; Bikdeli, B.; Ahluwalia, N.; Ausiello, J.C.; Wan, E.Y.; et al. Extrapulmonary manifestations of COVID-19. Nat. Med. 2020, 26, 1017–1032. [Google Scholar] [CrossRef] [PubMed]
- Klann, J.G.; Strasser, Z.H.; Hutch, M.R.; Kennedy, C.J.; Marwaha, J.S.; Morris, M.; Samayamuthu, M.J.; Pfaff, A.C.; Estiri, H.; South, A.M.; et al. Distinguishing Admissions Specifically for COVID-19 From Incidental SARS-CoV-2 Admissions: National Retrospective Electronic Health Record Study. J. Med. Internet Res. 2022, 24, e37931. [Google Scholar] [CrossRef] [PubMed]
- Ong, S.; Lim, W.Y.; Ong, J.; Kam, P. Anesthesia guidelines for COVID-19 patients: A narrative review and appraisal. Korean J. Anesthesiol. 2020, 73, 486–502. [Google Scholar] [CrossRef] [PubMed]
- You, Y.; Yang, X.; Hung, D.; Yang, Q.; Wu, T.; Deng, M. Asymptomatic COVID-19 infection: Diagnosis, transmission, population characteristics. BMJ Support. Palliat. Care 2021, 14, e220–e227. [Google Scholar] [CrossRef] [PubMed]
- Song, H.; Seddighzadeh, B.; Cooperberg, M.R.; Huang, F.W. Expression of ACE2, the SARS-CoV-2 Receptor, and TMPRSS2 in Prostate Epithelial Cells. Eur. Urol. 2020, 78, 296–298. [Google Scholar] [CrossRef] [PubMed]
- Liu, A.Q.; Chiu, P.K.; Yee, S.C.; Ng, C.F.; Teoh, J.Y. SARS-CoV-2 infection correlates with male benign prostatic hyperplasia deterioration. J. Intern. Med. 2023, 294, 775–783. [Google Scholar] [CrossRef] [PubMed]
- Hostpital Authority. HA Statistical Report. Available online: https://www3.ha.org.hk/data/HAStatistics/StatisticalReport/ (accessed on 25 June 2024).
- Wong, J.C.; Chan, H.L.; Tse, Y.K.; Yip, T.C.; Wong, V.W.; Wong, G.L. Statins reduce the risk of liver decompensation and death in chronic viral hepatitis: A propensity score weighted landmark analysis. Aliment. Pharmacol. Ther. 2017, 46, 1001–1010. [Google Scholar] [CrossRef] [PubMed]
- McAlister, F.A.; Hau, J.P.; Atzema, C.; McRae, A.D.; Morrison, L.J.; Grant, L.; Cheng, I.; Rosychuk, R.J.; Hohl, C.M. The burden of incidental SARS-CoV-2 infections in hospitalized patients across pandemic waves in Canada. Sci. Rep. 2023, 13, 6635. [Google Scholar] [CrossRef] [PubMed]
- Nikolla, D.A.; Oskvarek, J.J.; Zocchi, M.S.; Rahman, N.A.; Leubitz, A.; Moghtaderi, A.; Black, B.S.; Pines, J.M. Defining Incidental Versus Non-incidental COVID-19 Hospitalizations. Cureus 2024, 16, e56546. [Google Scholar] [CrossRef] [PubMed]
- Menni, C.; Valdes, A.M.; Polidori, L.; Antonelli, M.; Penamakuri, S.; Nogal, A.; Figueiredo, J.C.; Hu, C.; Molteni, E. Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: A prospective observational study from the ZOE COVID Study. Lancet 2022, 399, 1618–1624. [Google Scholar] [CrossRef] [PubMed]
- Balaphas, A.; Gkoufa, K.; Colucci, N.; Perdikis, K.C.; Gaudet-Blavignac, C.; Pataky, Z.; Carballo, S.; Ris, F.; Stirnemann, J.; Lovis, C.; et al. Abdominal pain patterns during COVID-19: An observational study. Sci. Rep. 2022, 12, 14677. [Google Scholar] [CrossRef] [PubMed]
- Raheman, F.J.; Rojoa, D.M.; Nayan Parekh, J.; Berber, R.; Ashford, R. Meta-analysis and metaregression of risk factors associated with mortality in hip fracture patients during the COVID-19 pandemic. Sci. Rep. 2021, 11, 10157. [Google Scholar] [CrossRef] [PubMed]
- Isla, A.; Landy, D.; Teasdall, R.; Mittwede, P.; Albano, A.; Tornetta, P., 3rd; Bhandari, M.; Aneja, A. Postoperative mortality in the COVID-positive hip fracture patient, a systematic review and meta-analysis. Eur. J. Orthop. Surg. Traumatol. 2023, 33, 927–935. [Google Scholar] [CrossRef] [PubMed]
- Tsui, K.H.M.; Chau, W.W.; Liu, W.H.; Tam, C.Y.; Yee, D.K.H.; Tso, C.Y.; Zhang, N.; Cheung, W.H.; Tang, N.; Wong, R.M. COVID-19 hip fracture outcomes: The role of Ct values and D-dimer levels? J. Orthop. Translat. 2023, 43, 14–20. [Google Scholar] [CrossRef] [PubMed]
- Todor, S.B.; Bîrluțiu, V.; Topîrcean, D.; Mihăilă, R.G. Role of biological markers and CT severity score in predicting mortality in patients with COVID-19: An observational retrospective study. Exp. Ther. Med. 2022, 24, 698. [Google Scholar] [CrossRef] [PubMed]
Urology (n = 8535) | General Surgery (n = 70,061) | p-Value | Orthopaedic Surgery (n = 47,438) | p-Value | |
---|---|---|---|---|---|
Age (mean ± SD) | 66.0 ± 18.4 | 63.2 ± 20.5 | <0.001 | 62.9 ± 22.2 | <0.001 |
Male (n, %) | 6004 (70.3%) | 37,520 (53.6%) | <0.001 | 22,965 (48.4%) | <0.001 |
Diabetes mellitus (n, %) | 1733 (20.3%) | 12,490 (17.8%) | <0.001 | 8534 (18.0%) | <0.001 |
Hypertension (n, %) | 3367 (39.4%) | 24,408 (34.8%) | <0.001 | 16,476 (34.7%) | <0.001 |
Hyperlipidemia (n, %) | 1727 (20.2%) | 12,578 (18.0%) | <0.001 | 8232 (17.4%) | <0.001 |
Obesity (n, %) | 422 (4.9%) | 3555 (5.1%) | 0.605 | 2366 (5.0%) | 0.866 |
Ischemic heart disease (n, %) | 716 (8.4%) | 5118 (7.3%) | <0.001 | 2962 (6.2%) | <0.001 |
Stroke (n, %) | 728 (8.5%) | 4736 (6.8%) | <0.001 | 2928 (6.2%) | <0.001 |
Smoking (n, %) | 245 (2.9%) | 1505 (2.1%) | <0.001 | 809 (1.7%) | <0.001 |
Alcoholism (n, %) | 158 (1.9%) | 1687 (2.4%) | 0.001 | 953 (2.0%) | 0.336 |
Urology (n = 8535) | General Surgery (n = 8525) | Standardized Mean Difference | Orthopaedic Surgery (n = 8535) | Standardized Mean Difference | |
---|---|---|---|---|---|
Age (mean) | 66.0 ± 18.4 | 66.0 | −0.001 | 66.0 | −0.004 |
Male (n, %) | 6004 (70.3%) | 5989 (70.2%) | −0.004 | 5994 (70.2%) | 0.003 |
Diabetes mellitus (n, %) | 1733 (20.3%) | 1673 (19.5%) | 0.018 | 1739 (20.4%) | −0.002 |
Hypertension (n, %) | 3367 (39.4%) | 3377 (39.6%) | −0.002 | 3361 (39.4%) | 0.001 |
Hyperlipidemia (n, %) | 1727 (20.2%) | 1743 (20.4%) | −0.005 | 1680 (19.7%) | 0.014 |
Obesity (n, %) | 422 (4.9%) | 396 (4.64%) | 0.014 | 345 (4.04%) | 0.042 |
Ischemic heart disease (n, %) | 716 (8.4%) | 673 (7.89%) | 0.018 | 671 (7.86%) | 0.019 |
Stroke (n, %) | 728 (8.5%) | 686 (8.04%) | 0.018 | 697 (8.17%) | 0.013 |
Smoking (n, %) | 245 (2.9%) | 200 (2.44%) | 0.023 | 221 (2.59%) | 0.017 |
Alcoholism (n, %) | 158 (1.9%) | 142 (1.73%) | 0.018 | 129 (1.51%) | 0.025 |
Urology (n = 8535) | General Surgery (n = 70,061) | Orthopaedic Surgery (n = 47,438) | |
---|---|---|---|
Incidental COVID-19 | 793 (9.3%) | 3329 (4.8%) | 2224 (4.7%) |
p-value * | N/A | <0.001 | <0.001 |
After propensity score matching | |||
Urology (n = 8535) | General surgery (n = 8535) | Orthopaedic surgery (n = 8535) | |
Incidental COVID-19 | 793 (9.3%) | 461 (5.4%) | 474 (5.6%) |
p-value * | N/A | <0.001 | <0.001 |
Urology (n = 793) | General Surgery (n = 3329) | Orthopaedic Surgery (n = 2224) | |
---|---|---|---|
1 | Acute retention of urine (n = 284, 35.8%) | Abdominal pain (n = 339, 10.2%) | Closed femur transcervical fracture (n = 185, 8.3%) |
2 | Haematuria (n = 221, 27.9%) | Rectal bleeding (n = 158, 4.8%) | Back pain (n = 182, 8.2%) |
3 | Urinary tract infection (n = 68, 8.6%) | Epigastric pain (n = 135, 4.1%) | Closed femur trochanteric fracture (n = 177, 8.0%) |
4 | Nephrostomy complications (n = 25, 3.2%) | Gastrointestinal haemorrhage (n = 114, 3.4%) | Hip joint pain (n = 69, 3.1%) |
5 | Loin pain-haematuria syndrome (n = 23, 2.9%) | Intestinal obstruction (n = 56, 1.7%) | Cellulitis and abscess of leg (n = 67, 3.0%) |
6 | Ureteric stone (n = 20, 2.5%) | Gastritis (n = 46, 1.4%) | Gangrene (n = 60, 2.7%) |
7 | Pyelonephritis (n = 19, 2.4%) | Acute cholecystitis (n = 39, 1.2%) | Closed distal radial fracture (n = 43, 1.9%) |
8 | Foley catheter complication (n = 16, 2.0%) | Choledocholithiasis (n = 29, 0.9%) | Knee pain (n = 39, 1.8%) |
9 | Scrotal/testicular pain (n = 12, 1.5%) | Constipation (n = 28, 0.8%) | Laceration (n = 28, 1.3%) |
10 | Prostatic hyperplasia (n = 9, 1.1%) | Duodenal ulcer (n = 27, 0.8%) | Decubitus ulcer (n = 26, 1.2%) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Liu, A.Q.; Choy, E.K.-H.; Chiu, P.K.-F.; Yee, C.-H.; Ng, C.-F.; Teoh, J.Y.-C. High Levels of Incidental COVID-19 Infection in Emergency Urology Admissions: A Propensity Score-Matched Real World Data Analysis across Surgical Specialties. Viruses 2024, 16, 1402. https://doi.org/10.3390/v16091402
Liu AQ, Choy EK-H, Chiu PK-F, Yee C-H, Ng C-F, Teoh JY-C. High Levels of Incidental COVID-19 Infection in Emergency Urology Admissions: A Propensity Score-Matched Real World Data Analysis across Surgical Specialties. Viruses. 2024; 16(9):1402. https://doi.org/10.3390/v16091402
Chicago/Turabian StyleLiu, Alex Qinyang, Eric Ka-Ho Choy, Peter Ka-Fung Chiu, Chi-Hang Yee, Chi-Fai Ng, and Jeremy Yuen-Chun Teoh. 2024. "High Levels of Incidental COVID-19 Infection in Emergency Urology Admissions: A Propensity Score-Matched Real World Data Analysis across Surgical Specialties" Viruses 16, no. 9: 1402. https://doi.org/10.3390/v16091402