Lower urinary tract symptoms and COVID-19


DOI: https://dx.doi.org/10.18565/urology.2021.5.78-83

A.N. Bernikov, A.A. Kupriyanov, R.V. Stroganov, 
O.A. Arefieva, L.A. Khodyreva, A.V. Zaitsev

1) Department of Urology Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Ministry of Health of the Russian Federation, Moscow, Russia; 2) State Budgetary Institution «Research Institute of Health Organization and Medical Management of the Moscow Department of Health», Moscow, Russia
The data presented in the review showed that the coronavirus affects not only the lungs, but also the organs of the urinary system. The new virus causes a mosaic, multi-organ disease with severe consequences after the egg and has a wide organotropism. The role of SARS-CoV-2 in the development of lower urinary tract symptoms (LUTs), which are manifested by frequent, imperative urges, dysuria, nocturia, is not entirely clear. It is assumed that biologically active substances, the activation of which is caused by a virus, play a certain role in the development of SNMP, namely the expression of angiotensin converting enzyme 2 (ACE2), cytokines, activation of toll-like receptor 4 (TLR4), etc.
An increase in cytokines that are released into the urine and / or expressed in the bladder and the presence of SNMP in patients with coronavirus infection have been called de novo urinary symptoms or COVID-19 associated cystitis (CAC) in the literature. Urinary symptoms de novo or associated cystitis COVID-19 (CAC) develops against the background of a complete lack of data for the presence of a bacterial pathogen in the urine. Despite the unusual manifestation of coronavirus infection, similar mechanisms of damage to urothelial cells in viral and bacterial infections give us the right to think about the use of pathogenetically justified prevention of the development of an inflammatory reaction in the urinary tract, as well as short-and long-term consequences of this disease.
For this purpose, it is necessary to recommend drugs that have a multifactorial effect: diuretic, anti-adhesive, anti-inflammatory and regulate the local immunity of the bladder mucosa. We assume that against this background, we can expect a decrease in the number of complications from the organs of the urinary system, and more successful rehabilitation of patients with coronavirus infection and in the post-ovarian period. Final conclusions and recommendations will be available after well-planned clinical trials have been conducted.
Keywords: SARS-CoV-2, urinary tract infections, LUTS, cytokines, COVID-19 associated cystitis (CAC), de novo urinary symptoms, D-mannose, proanticyanidins, vitamin D

About the Autors


Author for correspondence: L.A. Khodyreva – MD, State Budgetary Institution «Research Institute of Health Organization and Medical Management of the Moscow Department of Health», Moscow, Russia; e-mail: Khodyreva60@mail.ru


Бионика Медиа