Are patients’ fears of catching COVID-19 during an emergency hospital admission with an acute urological problem justified? A UK epicentre experience

ABSTRACT

Introduction & Objectives: During the first wave of COVID-19 patients’ anxieties around contracting the virus during an emergency hospital admission were high. As further COVID-19 surges are possible it is important for healthcare service providers to inform patients of the risk of catching COVID-19 after an emergency hospital admission. Our aim was to establish the risk of catching COVID-19 as a urology emergency inpatient in our Trust and to assess patients fears and attitudes towards seeking medical help for their acute urological problems. Materials & Methods: A single centre study was conducted. A retrospective audit of all urological emergency admissions was made over a 10-week period (mid- March – end of May) in 2019 and compared to (mid-March – end of May) 2020 during the COVID-19 pandemic. The number of patients who developed new COVID-19 symptoms whilst an in-patient or had positive swabs within 28 days of discharge was obtained. We performed a post discharge telephone survey of patients based on a COVID-19 fear questionnaire (FC19-HVQ) adapted from the validated Fear of COVID-19 scale. Results: Compared to 2019 (n=187), 2020 (n=122) there was a 35% reduction in the number of patients presenting acutely to our department. 43 of the 122 (35%) patients were swabbed on admission due to possible symptoms of COVID-19. One patient was found to be COVID-19 positive. 5 patients had further swabs during their admission;one patient who was negative on admission became positive whilst an inpatient. Accordingly, the overall in-hospital infection rate with COVID-19 was 0.82% (1 patient) during or within 28 days of discharge. There was no mortality (0%) related to COVID -19. The majority of patients were afraid to visit A&E or be admitted to hospital during the COVID-19 pandemic crisis. Fewer patients were afraid to visit their local Family Doctor (GP). 28% (n=14) of responders ignored their symptoms during the pandemic. Patients were reluctant to seek medical input during COVID-19 with up 64% (n=32) of them stating that they attempted treat themselves at home. There was also a degree of intentional delay to visit A&E and the hospital with 56% (n=28) of our patients admitting to having delayed their visit. Conclusions: The risk of contracting COVID-19 whilst a urology in patient in a COVID-19 epicentre was very low (0.82%) with no COVID-19 related mortality. Our data supports the message that patients with urological emergencies should be educated and encouraged to attend hospital, rather than staying at home, during future surges in the current pandemic. This is to prevent further non COVID-19 related harm from delayed presentations, undiagnosed pathologies and self-treatment approaches.