LAUSR

Introduction It is acknowledged that the COVID-19 pandemic has had a major impact on healthcare services around the globe with possible worse outcomes. It has resulted in stretch of resources with cancelled or delayed procedures. Patients with urinary calculi have also suffered the negative impact. This systematic review aims to assess the impact of the early COVID-19 pandemic on the presentation and management of urinary calculi around the globe. Methods We reviewed the impact of early COVID-19 on the clinically important aspects of stone disease using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched Medline, Embase and Central databases using themes of (COVID-19 OR Sars-Cov-2 OR pandemic OR coronavirus AND kidney stone, urinary calculi, urolithiasis and similar allied terms. Inclusion criteria were studies with data on both pre and COVID-19 period covering one or more of eight clinical domains. Results Our search returned 231 studies, after removal of duplicates, of which 18 studies were included for analysis. The number of patients presenting to hospital declined by 21-70% at the beginning of the pandemic while majority of studies reported increased associated complications. There are mixed reports in terms of delay to presentation and use of conservative management. There was a consistent trend towards reduction in elective procedures with wide variations (shock wave lithotripsy 38-98%, PCNL 94-100% and ureteroscopy 8%-98%) There was a trend towards increased nephrostomy insertion with the onset of the pandemic. Conclusion This review demonstrated the differences in the number of patients presenting to hospital, complication rates and management of urinary calculi, including surgical interventions, with the onset of the COVID-19 pandemic. It offers baseline global information that would help understand the impact of early pandemic, variations in practices and be useful for future comparisons.