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COVID-associated cystitis: the culprit behind the bladder woes post-COVID infection? A review

  • Urology - Review
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Abstract

Purpose

SARS-CoV-2 had a significant impact on public health since its declaration as a pandemic. It is linked to a high rate of multiple organ dysfunction syndrome (MODS) and a slew of long-term symptoms that are yet to be thoroughly investigated. Among these, genitourinary symptoms of an overactive bladder (increased frequency, urgency, and nocturia) have recently been identified and labeled as COVID-associated cystitis (CAC). This current research is performed to review this phenomenon.

Methods

A literature search was performed in MEDLINE, Cochrane, and Google Scholar databases and 185 articles were obtained in total, including reviews and trials involving CAC, which were screened using various methods, and 42 articles were gathered for the review.

Results

Among its multitude of symptoms, overactive bladder (OAB) leads to poorer outcomes. The inflammatory mediator-based theory and the ACE-2 receptor-based theory are two probable theories for how it harms the bladder urothelium. The expression of ACE-2 receptors during the pathogenesis of CAC warrants further investigation as ACE modulation may reveal more information about COVID-19 complications. Other comorbidities, immunocompromised patients, or patients with a history of urinary tract infections can also exacerbate this condition.

Conclusion

The scarce literature collected related to CAC gives us an insight into the symptomatology, pathophysiology, and possible treatment plans. Treatment choices are diverse among COVID-19-afflicted and unaffected patients for treating urinary symptoms which highlights the importance to distinguish between the two. CAC shows greater prevalence and morbidity when linked to other conditions, thereby warranting future developments in it.

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Data Availability

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

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Author notes

    Authors and Affiliations

    1. Soochow University, Suzhou, China

      Ananya Dhawan & Yashaank Kumar

    2. NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam, 531162, India

      Rohit Ganduboina

    3. Kyiv Medical University, Kiev, Ukraine

      Palak Dutta

    4. Gandhi Medical College, Hyderabad, India

      Gayathri Gandrakota

    5. Government Medical College, Anantapur, India

      Keerthi Palagati

    6. Kurnool Medical College, Kurnool, India

      Sai Nithin Avvaru

    7. K S Hegde Medical Academy, Mangaluru, India

      Arjun Sreekumar

    8. Malla Reddy Medical College for Women, Hyderabad, India

      Suchita Mylavarapu

    9. Apollo Medical College, Hyderabad, India

      Afshan Nizami

    10. Tbilisi State Medical University, Tbilisi, Georgia

      Alexis T. Babu

    11. Baylor College of Medicine, Houston, TX, USA

      Mahboob Alam

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    Contributions

    Conceptualization: AD, RG; methodology: AD, RG, YK; validation: AD, RG; formal analysis and investigation: AD, RG; data curation: RG, AD; writing—original draft: AD, RG, PD, YK, GG, SNA, SM, AN, ATB; visualization: AD, RG, YK, SNA; writing—review and editing: AD, RG, GG, YK, AN, PD, KP, AS, SNA, SM, ATB; editing: ATB, PD, KP, AS; supervision and project administration: MA.

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    Correspondence to Rohit Ganduboina.

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    Dhawan, A., Ganduboina, R., Dutta, P. et al. COVID-associated cystitis: the culprit behind the bladder woes post-COVID infection? A review. Int Urol Nephrol 55, 2367–2372 (2023). https://doi.org/10.1007/s11255-023-03700-3

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