Not as black as it is painted? The impact of the first wave of COVID-19 pandemic on surgical treatment of urological cancer patients in Poland - a cross-country experience.

Introduction: In the majority of Western European countries, the coronavirus disease (COVID-19) pandemic has led to a dramatic reduction in urooncological surgeries. Our objective was to evaluate the impact of the pandemic on volume and patterns of urooncological surgery in Poland. Material and methods: This is a retrospective analysis of 10 urologic centres in Poland. Data regarding major oncological procedures performed after the COVID-19 pandemic outbreak (March 15, 2020 - May 31, 2020) were evaluated and compared with data from the respective period in 2019. Results: Between March 15, 2020 and May 31, 2020, a total of 968 oncological procedures were performed in participating centres. When compared to the respective period in 2019 (1063 procedures) the overall number of surgeries declined by 8.9%. The reduction was observed for transurethral resection of bladder tumour (TURBT) (20.1%) and partial nephrectomies (PN) (16.5%). Surgical activity considering radical nephrectomy (RN), nephroureterectomy (NU), and radical prostatectomy (RP) remained relatively unchanged, whereas radical cystectomy (RC) burden showed a significant increase (90.9%). Characteristics of patients treated with TURBT, RC, NU, PN, and RN did not differ significantly between the compared periods, whereas RP in the COVID-19 period was performed more frequently in patients with a higher grade group (p = 0.028) and positive digital rectal examination (p = 0.007). Conclusions: Surgical activity for urological cancers in Poland has been maintained during the first wave of the COVID-19 pandemic. The Polish strategy in the initial period of the COVID-19 crisis mirrors the scenario of hard initial lockdown followed by adaptive lockdown, during which oncological care remained undisrupted and did not require particular priority triage.

Outcomes of COVID­19 in hospitalized kidney and liver transplant recipients: a single­center experience.

Introduction: Solid organ transplant recipients seem to be more susceptible to severe COVID-19. Objectives: Our study aimed to assess the clinical outcomes of COVID-19 in kidney (KTRs) and liver transplant recipients (LTRs). Patients and methods: In this single-center study, the medical records of KTRs and LTRs with PCR-confirmed COVID-19 admitted between November 9, 2020 and February 26, 2021 were retrospectively reviewed. Results: Overall, 41 patients, including 32 KTRs (78%), one kidney-pancreas transplant recipient (2.4%), and 8 LTRs (19.5%) were included. Seven patients (17%) experienced COVID-19 in the first month after transplantation. Among the KTRs, 72% were male and the median (interquartile range) age was 54 (47­62) years. During a median (interquartile range) of 12 (8­18) days of hospital stay, 72.7% of the KTRs experienced acute kidney injury, 45.5% developed acute respiratory distress syndrome (ARDS), and 30.3% died. Baseline estimated glomerular filtration rate, respiratory rate on admission, and diabetes mellitus constituted independent risk factors for in-hospital mortality in the KTRs. The LTRs experienced relatively mild COVID-19: only 2 patients (25%) required oxygen supplementation and a single patient (12.5%) died of severe ARDS. Conclusion: In summary, hospitalized KTRs with COVID-19 are at a high risk of acute kidney injury, ARDS, and death.