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The current COVID pandemic has been a worldwide challenge for over a year. It can affect an individual in various ways. According to the World Health Organization, the classical signs are dry cough, fever and shortness of breath. In addition, a change in smell and taste are also implicated. This paper reveals that increased urinary frequency may be an important symptom. A retrospective and prospective review was performed of patients’ history of urinary frequency on admission to a COVID ward. Fifty-seven individuals tested positive for COVID-19 upon nasopharyngeal swab. Seven reported increased urinary frequency. Micturition protocols revealed an average of 13.7 voids per day on the day of admission, reducing to 11.6 on day five. Urinary tract infections, prostatitis and acute kidney injury were not evident. Patients maintained normal creatinine and normal prostate specific antigen (PSA) levels; no increased residual urine was found. COV-2 RNA was not detected in any urinary specimen. Two patients were found to have COV-2 RNA in serum. No individual required ICU admission. The reason for an increase in urinary frequency is unclear. Viral cystitis secondary to COVID-19 may be responsible. On a molecular level, replication of COV-2 RNA in urothelial cells or local endothelialitis may be responsible in such cases. This mechanism is well-illustrated within this paper. Further research will be required to establish or exclude the incidence of viral cystitis in such cases.

Urinary frequency as a possibly overlooked symptom in COVID-19 patients: does SARS-CoV-2 cause viral cystitis?
Mumm JN, Osterman A, Ruzicka M, et al.
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Arun K Sharma

West Herts NHS Trust (Watford General Hospital)

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