The main symptoms in patients infected with SARS-CoV-2 ( Covid-19) novel virus are respiratory such as cough, hypoxia and shortness of breathing. However, some studies found involvement with other organs, such as cardiovascular, gastrointestinal and urinary systems. Lower Urinary Tract Symptoms ( LUTS ) mainly Urinary urgency and frequency related to Covid-19 infection was also described and reported in addition to hematuria.    

Aim:
To assess  and identify the effect of Covid-19 infection on lower urinary tract symptoms manifestation on the patient with COVID-19

A validated predesigned questionnaire about overactive bladder symptoms  was modified to evaluate the effect of Covid-19 infection on lower urinary tract symptoms as a cross-sectional observational study. It was distributed as an electronic software questionnaire during May 2022, and the public were asked to take part of it.

A total of 407 people with a mean±SD age of 43±12 years (range 18 to 75) agreed to participate. 252 (62%) were females and 155 were male ( 38% ). Of the participants, 13% have cardiac problems, 11% have diabetes mellitus, and 72% were healthy.  179 (44%) reported to have Covid-19 infection, from which 53 (30%) were health care providers. Among those infected, 19% reported feeling of an urgency, 27% increase in  frequency, 15% woke up at night to urinate more frequently; 10% reported experiencing increased in overall LUTS during the infection, but 13% reported experiencing these symptoms following recovery. Compared to those infected, none of the non-infected ones experienced the aforementioned symptoms. Only 15% from those infected sought medical advice, and the majority (91%) said that their urinary symptoms did not affect their social lives.

With the global rise of Covid-19 cases world-wide , few studies were published looking into the effect of Covid-19 infection on lower urinary tract symptoms with contradictory results.
Our results showed a significant increase in LUTS mainly Urgency ( 19% ), Frequency ( 27% ) and Noctuira ( 15% ) in the Covid-19 infected patients while the other Non-infected group ( 228 participant -56% ), none of them reported any bothersome LUTS symptoms which is a statically significant findings. On the other hand, we published previously our data about the prevalence of Overactive Bladder symptoms among Saudi women which ranged from 44%-72% which might contradict our findings in this study but our interpretation that the participants  concerns and interpretations during the Covid-19 pandemic were more occupied by the Covid-19 issues. Another similar Cohort study done by Marand et al to assess LUTS in Covid-19  238 admitted patients and it showed no reports of experiencing LUTS even though after the urine was examined. Other studies reported an active association between COVID-19 infection and LUTS

According to our findings, Covid-19 positive cases may suffer from an increase incidence  in lower urinary tract symptoms with different levels of severity compared to the non-Covid-19 patients . More studies with larger sample size are required to explore this issue.

World Health Organization. COVID-19 clinical management: living guidance, 25 January 2021. No. WHO/2019-nCoV/clinical/ 2021.1. World Health Organization, 2021.
Marand, Aida Javan Balegh, et al. Lower urinary tract signs and symptoms in patients with COVID-19. BMC Infectious Diseases, 2021,
Bani-Hani M, Alnifise M, Al-Zubi M, Albazee E, Al-Balawi M, Majeed H, et al. Evaluation of lower urinary tract symptoms among male COVID-19 patients during the second wave: An observational study. Urol Ann 2022;14:372-6.