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2020 ; 6
(5
): 1070-1085
Nephropedia Template TP
gab.com Text
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English Wikipedia
A Systematic Review on Guidelines and Recommendations for Urology Standard of
Care During the COVID-19 Pandemic
#MMPMID32532703
Heldwein FL
; Loeb S
; Wroclawski ML
; Sridhar AN
; Carneiro A
; Lima FS
; Teoh JY
Eur Urol Focus
2020[Sep]; 6
(5
): 1070-1085
PMID32532703
show ga
CONTEXT: The first case of the new coronavirus, severe acute respiratory syndrome
coronavirus 2 (SARS-CoV2), was identified in Wuhan, China, in late 2019. Since
then, the coronavirus disease 2019 (COVID-19) outbreak was reclassified as a
pandemic, and health systems around the world have faced an unprecedented
challenge. OBJECTIVE: To summarize guidelines and recommendations on the urology
standard of care during the COVID-19 pandemic. EVIDENCE ACQUISITION: Guidelines
and recommendations published between November 2019 and April 17, 2020 were
retrieved using MEDLINE, EMBASE, and CINAHL. This was supplemented by searching
the web pages of international urology societies. Our inclusion criteria were
guidelines, recommendations, or best practice statements by international urology
organizations and reference centers about urological care in different phases of
the COVID-19 pandemic. Our systematic review was conducted according to the
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)
statement. Of 366 titles identified, 15 guidelines met our criteria. EVIDENCE
SYNTHESIS: Of the 15 guidelines, 14 addressed emergency situations and 12
reported on assessment of elective uro-oncology procedures. There was consensus
on postponing radical prostatectomy except for high-risk prostate cancer, and
delaying treatment for low-grade bladder cancer, small renal masses up to T2, and
stage I seminoma. According to nine guidelines that addressed endourology,
obstructed or infected kidneys should be decompressed, whereas nonobstructing
stones and stent removal should be rescheduled. Five guidelines/recommendations
discussed laparoscopic and robotic surgery, while the remaining recommendations
focused on outpatient procedures and consultations. All recommendations
represented expert opinions, with three specifically endorsed by professional
societies. Only the European Association of Urology guidelines provided
evidence-based levels of evidence (mostly level 3 evidence). CONCLUSIONS: To make
informed decisions during the COVID-19 pandemic, there are multiple national and
international guidelines and recommendations for urologists to prioritize the
provision of care. Differences among the guidelines were minimal. PATIENT
SUMMARY: We performed a systematic review of published recommendations on
urological practice during the coronavirus disease 2019 (COVID-19) pandemic,
which provide guidance on prioritizing the timing for different types of
urological care.