New-Onset Bladder Symptoms in Discharged COVID Patients

Men and women who have been hospitalized with COVID-19 have reported new-onset severe genitourinary symptoms, including increased frequency, urgency, and nocturia that can cause multiple nighttime waking events, according to a case series presented at the American Urological Association 2021 Annual Meeting. Researchers have termed the symptoms COVID-19–associated cystitis (CAC).

The study compared 53 patients who had been discharged in recent weeks after a confirmed COVID-19 hospitalization and were reporting new-onset urinary symptoms with 12 asymptomatic control patients. The average age of patients reporting CAC symptoms was 65 years.

The majority of participants reporting bladder symptoms had no evidence of SARS-CoV-2 in their urine. However, assays showed that levels of inflammatory cytokines were significantly higher in urine samples from COVID-19 patients, especially those with CAC, than from control patients.

The report, which suggests that COVID-19 affects the urinary system, further underscores the systemic nature of SARS-CoV-2 infection. It is unclear whether the overactive bladder symptoms or exacerbations will fade with time after COVID-19 recovery. Questions also remain about treatment options for patients who do not have virus in their urine but do have elevated levels of pro-inflammatory markers, because treatments for overactive bladder are not geared toward treating an inflammatory response; rather, they aim to calm the muscles of the bladder.

Chancellor MB, Wills M, Timar R, et al. COVID-19 associated cystitis (CAC): increased urinary symptoms and biomarkers of inflammation in urine in patients with acute COVID-19. Presented at: AUA2021 Virtual Experience held September 10-13, 2021. Poster MP29-15. 

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