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Trends of Acute Renal Colic During the COVID-19 Lockdown: A Saudi Arabian Experience

Abstract

Introduction

A Saudi Arabian Experience | The COVID-19 pandemic offers a previously unheard-of problem for global healthcare systems. One of the first nations to suffer a lockdown and the postponing of elective surgery was Saudi Arabia. This study’s goal was to evaluate the trends in acute renal colic cases that presented to our emergency room.

Methods

A Saudi Arabian Experience All patients who arrived with acute renal colic during the lockdown period were the focus of this retrospective analysis (March 23, 2019 to June 20, 2019). Data about the patients and stones were gathered. Data on the patient included comorbidities, BMI, age, and gender. Stone size, position, side, blockage and UTI evidence, as well as planned and carried out management, were all included in the data on stones.

Results

A Saudi Arabian Experience | 137 patients in total were found; 92 (67.2%) of them were men with an average age of 44 16 years. 47 (34.3%) people (with a positive history of urolithiasis) reported this. Non-contrast CTs made up the majority of the first examinations (93.4%). The majority of patients (93%) and the majority of their stones (81.2%) were ureteric stones. A total of 32 patients (32.4%) had UTI and 63.4% had blockage, according to the data. 73.7 percent of the patients received medicinal expulsive treatment (MET). Only 2.2% of those were not managed as intended.

Conclusion

The observed trend demonstrates that the management’s actions throughout the lockdown were consistent with the initial suggestions. This could be because METs were often used to treat individuals with stones between 5 and 10 mm in size. To produce verifiable proof, more extensive data collection is required. Such information is necessary to build guidelines for emergency lockdown scenarios and to provide management a clear direction.

Introduction

A Saudi Arabian Experience When a stone is present in the urinary system, it can cause abrupt, intense discomfort known as acute renal colic. The urinary tract system and the stone can both arise anyplace. In most cases, discomfort starts at the costovertebral angle and travels anteriorly and inferiorly to the groyne or testicles . Along with other symptoms, flank pain, back pain, nausea, vomiting, fever, and dysuria are signs of renal colic .

In Saudi Arabia, the prevalence of urolithiasis was 6.2%, with 6.6% of men and 5.8% of women affected . A thorough history, physical examination, radiological imaging, such as non-contrast helical computed tomography and ultrasound, are mostly used to make the diagnosis .

Due to its excellent sensitivity and specificity, non-contrast computerised tomography has emerged as the preferred imaging examination to make the diagnosis of renal colic . Observation, medicinal expulsive therapy, pain management, and surgical intervention are all included in the treatment . Numerous problems, including renal failure, ureteral stricture, infection, urine extravasation, and perinephric abscess, can result from stones .

The recently identified coronavirus, COVID-19, is the virus that causes the illness. The World Health Organization declared COVID-19 to be a pandemic in March 2020 [12]. As a result, many nations, including Saudi Arabia, took preventative measures to stop the infection’s spread, reduce the likelihood that health facilities would become overcrowded, and safeguard their populations from COVID-19 infection.

A Saudi Arabian Experience includes a partial 24 hour restriction, the postponement of the elective procedure, and others. These preventive steps may cause renal colic patients to present later than expected, which might worsen their clinical condition and raise their risk of complications.

We are aware of a few papers that analyse the trend of renal colic during the COVID-19 pandemic. In Italy, a research was done that compared the visits made during the epidemic to those made the year before. The study revealed a 38.9% decline in the number of urgent visits during the pandemic, a 51.1% decrease in the number of urgent visits for patients who went straight to the emergency room, but no change in the number of urgent care visits suggested by GPs..

A Saudi Arabian Experience As a result, the rate of ED visits dropped from 75% to 60% while the percentage of GP visits sought rose from 25% to 40%. Notably, the rate of visits from the ED for renal colic, LUTS, and other illnesses that were not clearly described increased, whereas the rate of visits from patients who had been recommended by GPs declined. Furthermore, a multicenter investigation was carried out in Saudi Arabia.

They contrast the COVID-19 period with the corresponding months in 2019. According to the survey, the number of elective treatments fell by 34.3% in the first quarter of 2020 compared to the same quarter in 2019. Emergency procedures, meanwhile, decreased by 9.3% between the aforementioned time periods.

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