ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2025
The impact of the COVID-19 pandemic on kidney stone management in a single-payer system.
Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionWe examined the effects of the COVID-19 pandemic on the incidence of kidney stone acute care visits and interventions.
methodsWe conducted a retrospective, population-based cohort study using linked administrative healthcare data in the province of Ontario, Canada. We included all patients who, between March 1, 2018, and September 30, 2021, presented to an emergency department (ED) or were admitted to hospital with renal colic (RC), as well as patients who underwent stenting, nephrostomy tube (NT) insertion, shockwave lithotripsy (SWL), ureteroscopy (URS), or percutaneous nephrolithotomy (PCNL). Using univariate and multivariable analyses, outcomes of interest were compared before and after the onset of COVID-19.
resultsOur cohort included 149 006 unique patients; there were 74 994 pre- vs. 94 067 peri-COVID RC episodes (p=0.74). Peri-pandemic patients were more likely to be sicker, female, and from marginalized communities. Mean time from temporizing to definitive intervention increased in the first three months of the pandemic (17.9 vs. 32 days), but no statistically significant effect on the overall proportion of patients undergoing definitive intervention was observed. The onset of COVID-19 was associated with a 29.5% reduction in SWL and a 7.9% and 5.4% increase in URS and NT use, respectively. Hospital admissions for RC increased by 10.9%, while intensive care unit admissions decreased by 25% during the pandemic.
conclusionsRC incidence and intervention rates were similar before and during the pandemic; however, patient demographics and morbidity differed. Understanding these trends can inform protocols for streamlining care in response to analogous strains on publicly funded healthcare systems.
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