Inpatient care for urological patients in a pandemic of the coronavirus disease-covid-19 infection

Since the first cases of coronavirus disease were detected in Wuhan (Hubei Province, China) in December 2019, the spread distribution of COVID-19 has expanded so much that the World Health Organization declared COVID-19 a pandemic. The most common symptoms of corona-virus infection are fever (85-90%), cough (65-70%), general weakness (35-40%), shortness of breath or feeling short of breath (15-20%);less common symptoms such as myalgia, headaches, sore throat and chills (10-15%). Currently, cases of infection are recorded in almost all countries of the world, there is a daily increase in the number of infected by an average of 100,000, and the death toll by average estimates is over 3,000,000. At present time, the “leading” position in the number of cases of COVID-19 detected belongs to the United States, in which over the entire observation period, more than 32,000,000 thousand cases were recorded. Another badly affected region is Europe, in which more than 43,000,000 thousand cases were recorded. The rapid growth in the number of newly diagnosed cases of COVID-19 dictates the need to search for optimal ways of providing medical care. It is obvious that inpatient practice carrying high risk of infection for patients as well as for medical stuff. Moreover, postoperative mortality rate in infected patients may be as high as 20%. Since the pandemic onset many authors and societies have provided recommendations on how the risk of infection during inpatient practice should be reduced. This article discusses the options for providing inpatient care to urological patients in a pandemic of the coronary viral infection COVID-19.

COVID-19: impact on the urological service of the Russian Federation

Introduction. In a pandemic of COVID-19 the health systems of all countries are under high pressure and are forced to change depending on the epidemiological situation. Materials and methods. To improve care for patients with urological diseases, the authors created a survey for urologists and for heads of clinics. 1023 urologists from the Russian Federation took in this survey. The survey was posted on the Russian urological information portal Uroweb.ru during the period from 5th April to 7th April 2020. Urologists were asked to answer 6 questions about their work during the COVID-19 pandemic. Results. 19% of urologists noted a complete cessation of care, and 43% of urologists started to provide it remotely. The number of planned surgery has sharply decreased, only 8% of surveyed didn't note reducing of surgeries, and 55% answered that surgeries are not currently performing. 75% of doctors believe that testing for COVID-19 should be carried out before hospitalization of the patient, 6% - in a hospital setting, only 17% of respondents consider it is not necessary. Conclusion. Medical care standards for urological patients are undergoing changes due to the active spread of coronavirus infection. For today there are no strict recommendations on the timing of planned surgery. It is necessary to minimize the pressure on equipment, hospital bed capacity as well as on assisting doctors. Prevention of complications in patients whose treatment may be delayed is important so the decision to postpone operations should be carefully considered and rational. Введение. В условиях пандемии COVID19 системы здравоохранения всех стран претерпевают высокую нагрузку и вынуждены изменяться в зависимости от эпидемиологической ситуации. Материалы и методы. Для улучшения помощи пациентам с урологическими заболеваниями авторы провели опрос врачей-урологов, а также руководителей клиник. В опросе приняли участие 1023 урологов из Российской федерации. Опрос проводился на российском урологическом информационном портале Uroweb.ru в период с 5 по 7 апреля 2020 года. Урологам было предложено ответить на 6 вопросов, касающихся их работы в период пандемии COVID-19. Результаты. 19% урологов отметили полное прекращения оказания урологической помощи, при этом 43% урологов стали оказывать консультативную дистанционно. Резко снизилось количество плановых оперативных вмешательств, лишь у 8% прошедших анкетирование оперативная деятельность не снижена, а у 55% - не выполняется в настоящее время. 75% врачей считают, что тестирование на COVID-19 необходимо проводить до госпитализации пациента, 6% - в условиях стационара, лишь 17% опрошенных считают это необязательным пунктом. Выводы. Стандарты оказания медицинской помощи урологическим больным претерпевают изменения вследствие активного распространения коронавирусной инфекции. На сегодняшний день не существует строгих рекомендаций по срокам выполнения плановых оперативных вмешательств. Необходимо минимизировать нагрузку на оборудование, коечный фонд учреждений, а также на врачей, оказывающих помощь. Немаловажным является профилактика осложнений у пациентов, чье лечение может быть отсрочено, поэтому решение о переносе операций должно быть тщательно обдуманным и рациональным.

[Assessment of the psychological status of urologists during the COVID-19 pandemic]

The aim of this study was to analyze the symptoms of depression, anxiety, and stress in urologists during the COVID-19 pandemic. MATERIALS AND METHODS: 90 urologists aged 25 to 60 years (M=37.27, S.D.=9.53), 93% of them were men, participated in the online survey. They answered questions about their attitude to their job as doctors and the impact of COVID-19. They filled out the Depression, Anxiety and Stress Scales (DASS-21), the Ten Item Personality Inventory (TIPI) and answered questions assessing their sense of control. RESULTS: The greatest concern among urologists is the risk of getting infected with COVID-19 (for 30% of the doctors). 43% of urologists state that their profession interesting. A positive attitude to work, as well as the Big Five traits (Conscientiousness, Emotional Stability and Agreeableness) are associated with lower levels of depression, anxiety, stress and lack of control. Working with COVID-19 patients reduces stress and increases the sense of control. Age and high levels of Emotional Stability predicted lower levels of anxiety, depression and stress. DISCUSSION: Working with COVID-19 patients allows doctors to feel more control over what is happening. A sense of control, in turn, and a positive attitude towards work are associated with a lower levels of depression, anxiety and stresssymptoms. CONCLUSION: The results of this study can be used in selection of therapeutic targets for psychotherapy, administered to doctors;in prevention of symptoms of anxiety, stress and depression among doctors;and in professional selection of doctors for working in crisis situations.

Оказание стационарной помощи пациентам урологического профиля в условиях пандемии коронаровирусной инфекции covid-19

Objective. Since the first cases of Coronavirus Disease were detected in Wuhan (Hubei Province, China) in December 2019, the spread distribution of COVID-19 has expanded so much that the World Health Organization declared COVID-19 a pandemic. Materials. Currently, cases of infection are recorded in almost all countries of the world, there is a daily increase in the number of infected by an average of 100 000, and the death toll by average estimates is over 115 000. At present time, the «leading» position in the number of cases of COVID-19 detected belongs to the United States, in which over the entire observation period, more than 500 000 cases were recorded. In Spain, Italy, France and Germany the total number of cases exceeded 526 000 people in less than a month. The rapid growth in the number of newly diagnosed cases of COVID-19 dictates the need for search for optimal ways of providing medical care. Clinical practice and results. This article discusses the options for providing inpatient care to urological patients in a pandemic of the coronary viral infection COVID-19. Clinical practice is described and a list of urological diseases is presented, the surgical treatment of which is possible in a pandemic. Intraoperative measures have been developed to reduce the risk of viral contamination during laparoscopic and robot-assisted operations. The routing and scope of work with patients suffering from acute urological diseases are described in detail: renal colic, acute obstructive pyelonephritis, macrohematuria, acute urinary retention. Conclusion. The principles of the organization of work of the urological department and precautions in identifying patients with COVID- 19 have been developed. Введение. С момента выявления первых случаев коронаровирусной инфекции (КВИ) в городе Ухань (провинция Хубэй, КНР) в декабре 2019 года география распространения COVID-19 расширилась настолько, что Всемирная Организация Здравоохранения присвоила вспышке статус пандемии. Материалы и методы. В настоящее время случаи инфекции зафиксированы практически во всех странах мира, отмечается ежедневный прирост числа инфицированных в среднем на 100 000 человек, а количество погибших по средним подсчетам составляет свыше 115 000 человек. В настоящее время «лидирующие» позиции по числу выявленных случаев КВИ принадлежат США, где за весь период наблюдения зафиксировано свыше 526 000 заболевших. В Испании, Италии, Франции и Германии меньше, чем за месяц, суммарное число заболевших превысило 570 000 человек. Молниеносный рост числа вновь выявленных случаев заболевания КВИ предопределяет поиск оптимальных путей оказания медицинской помощи. Клиническая практика и результаты. В статье рассмотрены варианты оказания стационарной помощи пациентам урологического профиля в условиях пандемии коронавирусной инфекции COVID-19. Описана клиническая практика и представлен список урологических заболеваний, оперативное лечение которых возможно в условиях пандемии. Разработаны интраоперационные меры для снижения риска вирусной контаминации при выполнении лапароскопических и робот-ассистированных операций. Подробно описана маршрутизация и объем работы с пациентами, страдающими острыми урологическими заболеваниями: почечная колика, острый обструктивный пиелонефрит, макрогематурия, острая задержка мочи. Выводы. Авторами были разработаны принципы организации работы урологического отделения и меры предосторожности при выявлении больных с COVID-19.

Inpatient care for urological patients in a pandemic of the coronavirus disease infection COVID-19

Objective. Since the first cases of Coronavirus Disease were detected in Wuhan (Hubei Province, China) in December 2019, the spread distribution of COVID-19 has expanded so much that the World Health Organization declared COVID-19 a pandemic. Materials. Currently, cases of infection are recorded in almost all countries of the world, there is a daily increase in the number of infected by an average of 100 000, and the death toll by average estimates is over 115 000. At present time, the «leading» position in the number of cases of COVID-19 detected belongs to the United States, in which over the entire observation period, more than 500 000 cases were recorded. In Spain, Italy, France and Germany the total number of cases exceeded 526 000 people in less than a month. The rapid growth in the number of newly diagnosed cases of COVID-19 dictates the need for search for optimal ways of providing medical care. Clinical practice and results. This article discusses the options for providing inpatient care to urological patients in a pandemic of the coronary viral infection COVID-19. Clinical practice is described and a list of urological diseases is presented, the surgical treatment of which is possible in a pandemic. Intraoperative measures have been developed to reduce the risk of viral contamination during laparoscopic and robot-assisted operations. The routing and scope of work with patients suffering from acute urological diseases are described in detail: renal colic, acute obstructive pyelonephritis, macrohematuria, acute urinary retention. Conclusion. The principles of the organization of work of the urological department and precautions in identifying patients with COVID- 19 have been developed. Введение. С момента выявления первых случаев коронаровирусной инфекции (КВИ) в городе Ухань (провинция Хубэй, КНР) в декабре 2019 года география распространения COVID-19 расширилась настолько, что Всемирная Организация Здравоохранения присвоила вспышке статус пандемии. Материалы и методы. В настоящее время случаи инфекции зафиксированы практически во всех странах мира, отмечается ежедневный прирост числа инфицированных в среднем на 100 000 человек, а количество погибших по средним подсчетам составляет свыше 115 000 человек. В настоящее время «лидирующие» позиции по числу выявленных случаев КВИ принадлежат США, где за весь период наблюдения зафиксировано свыше 526 000 заболевших. В Испании, Италии, Франции и Германии меньше, чем за месяц, суммарное число заболевших превысило 570 000 человек. Молниеносный рост числа вновь выявленных случаев заболевания КВИ предопределяет поиск оптимальных путей оказания медицинской помощи. Клиническая практика и результаты. В статье рассмотрены варианты оказания стационарной помощи пациентам урологического профиля в условиях пандемии коронавирусной инфекции COVID-19. Описана клиническая практика и представлен список урологических заболеваний, оперативное лечение которых возможно в условиях пандемии. Разработаны интраоперационные меры для сниженРя риска вирусной контаминации при выполнении лапароскопических и робот-ассистированных операций. Подробно описана маршрутизация и объем работы с пациентами, страдающими острыми урологическими заболеваниями: почечная колика, острый обструктивный пиелонефрит, макрогематурия, острая задержка мочи. Выводы. Авторами были разработаны принципы организации работы урологического отделения и меры предосторожности при выявлении больных с COVID-19.