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. 2021 Sep;39(9):3127-3138.
doi: 10.1007/s00345-020-03246-4. Epub 2020 May 27.

A systematic review on COVID-19: urological manifestations, viral RNA detection and special considerations in urological conditions

Vinson Wai-Shun Chan  1 , Peter Ka-Fung Chiu  2 , Chi-Hang Yee  2 , Yuhong Yuan  3 , Chi-Fai Ng  2 , Jeremy Yuen-Chun Teoh  4
Affiliations

A systematic review on COVID-19: urological manifestations, viral RNA detection and special considerations in urological conditions

Vinson Wai-Shun Chan et al. World J Urol. 2021 Sep.

Abstract

Purpose and objective: We performed a systematic review on COVID-19 and its potential urological manifestations.

Methods: A literature search was performed using combination of keywords (MeSH terms and free text words) relating to COVID-19, urology, faeces and stool on multiple databases. Primary outcomes were the urological manifestations of COVID-19, and SARS-CoV-2 viral RNA detection in urine and stool samples. Meta-analyses were performed when there were two or more studies reporting on the same outcome. Special considerations in urological conditions that were relevant in the pandemic of COVID-19 were reported in a narrative manner.

Results: There were a total of 21 studies with 3714 COVID-19 patients, and urinary symptoms were absent in all of them. In patients with COVID-19, 7.58% (95% CI 3.30-13.54%) developed acute kidney injury with a mortality rate of 93.27% (95% CI 81.46-100%) amongst them. 5.74% (95% CI 2.88-9.44%) of COVID-19 patients had positive viral RNA in urine samples, but the duration of viral shedding in urine was unknown. 65.82% (95% CI 45.71-83.51%) of COVID-19 patients had positive viral RNA in stool samples, which were detected from 2 to 47 days from symptom onset. 31.6% of renal transplant recipients with COVID-19 required non-invasive ventilation, and the overall mortality rate was 15.4%.

Conclusions: Acute kidney injury leading to mortality is common amongst COVID-19 patients, likely as a result of direct viral toxicity. Viral RNA positivity was detected in both urine and stool samples, so precautions are needed when we perform transurethral or transrectal procedures.

Keywords: Acute kidney injury; COVID-19; SARS-CoV-2; Stool; Urine; Urology; Viral RNA.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram
Fig. 2
Fig. 2
a Pooled prevalence of acute kidney injury, and b pooled mortality rate in patients with acute kidney injury
Fig. 3
Fig. 3
a Pooled rate of urine RNA positivity, and b pooled rate of stool RNA positivity
See this image and copyright information in PMC

References

    1. Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, Liu L, Shan H, Lei C-l, Hui DSC, Du B, Li L-j, Zeng G, Yuen K-Y, Chen R-c, Tang C-l, Wang T, Chen P-y, Xiang J, Li S-y, Wang J-l, Liang Z-j, Peng Y-x, Wei L, Liu Y, Hu Y-h, Peng P, Wang J-m, Liu J-y, Chen Z, Li G, Zheng Z-j, Qiu S-q, Luo J, Ye C-j, Zhu S-y, Zhong N-s. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 doi: 10.1056/NEJMoa2002032. - DOI - PMC - PubMed
    1. Wong SH, Lui RN, Sung JJ. Covid-19 and the digestive system. J Gastroenterol Hepatol. 2020 doi: 10.1111/jgh.15047. - DOI - PubMed
    1. Cheung KS, Hung IFN, Chan PPY, Lung KC, Tso E, Liu R, Ng YY, Chu MY, Chung TWH, Tam AR, Yip CCY, Leung K-H, Yim-Fong Fung A, Zhang RR, Lin Y, Cheng HM, Zhang AJX, To KKW, Chan K-H, Yuen K-Y, Leung WK. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from the Hong Kong cohort and systematic review and meta-analysis. Gastroenterology. 2020 doi: 10.1053/j.gastro.2020.03.065. - DOI - PMC - PubMed
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535. doi: 10.1136/bmj.b2535. - DOI - PMC - PubMed
    1. Chen Y, Chen L, Deng Q, Zhang G, Wu K, Ni L, Yang Y, Liu B, Wang W, Wei C, Yang J, Ye G, Cheng Z. The presence of SARS-CoV-2 RNA in feces of COVID-19 patients. J Med Virol. 2020 doi: 10.1002/jmv.25825. - DOI - PubMed

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