Are urologists in trouble with SARS-CoV-2? Reflections and recommendations for specific interventions

Application of Nanotechnology in COVID-19 Infection: Findings and Limitations

There is an urgent need to address the global mortality of the COVID-19 pandemic, as it reached 6.3 million as of July 2022. As such, the experts recommended the mass diagnosis of SARS-CoV-2 infection at an early stage using nanotechnology-based sensitive diagnostic approaches. The development of nanobiosensors for Point-of-Care (POC) sampling of COVID-19 could ensure mass detection without the need for sophisticated laboratories or expert personnel. The use of Artificial Intelligence (AI) techniques for POC detection was also proposed. In addition, the utilization of various antiviral nanomaterials such as Silver Nanoparticles (AgNPs) for the development of masks for personal protection mitigates viral transmission. Nowadays, nano-assisted vaccines have been approved for emergency use, but their safety and effectiveness in the mutant strain of the SARS-CoV-2 virus remain challenging. Methodology: Updated literature was sourced from various research indexing databases such as PubMed, SCOPUS, Science Direct, Research Gate and Google Scholars. Result: We presented the concept of novel nanotechnology researched discovery, including nano-devices, electrochemical biosensing, nano-assisted vaccine, and nanomedicines, for use in recent times, which could be a formidable step for future management of COVID-19.

Impact of SARS-CoV-2 (COVID-19) on Fixed Operating Room Times in Urologic Surgeries

Objective

To evaluate the impact of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, on operating room (OR) efficiency for urologic procedures using the concept of fixed OR times.

Patients and Methods

Over a 24-month period, urology OR data were prospectively collected. Operations were divided into fixed and variable time points. The fixed OR times were in-roomw to anesthesia-release time, anesthesia-release to cut time, in-room to cut time, and close to wheels-out time. Data from January 1, 2019, to December 31, 2019, were pre-COVID-19 data, and data from April 1, 2020, to December 31, 2020, were post-COVID-19 data. Operations were grouped into endoscopic, implant, major open, and robotic-assisted cases. In the post-COVID-19 era, all patients had a negative polymerase chain reaction test result within 48 hours of operation. The Wilcoxon rank sum test was used to compare the fixed OR times between the pre- and post-COVID-19 eras.

Results

A total of 3189 procedures were evaluated: 2058 endoscopic operations (1124 in the pre-COVID-19 era and 934 in the post-COVID-19 era), 343 implant procedures (192 in the pre-COVID-19 era and 151 in the post-COVID-19 era), 222 major open procedures (119 in the pre-COVID-19 era and 103 in the post-COVID-19 era), and 566 robotic-assisted procedures (338 in the pre-COVID-19 era and 228 in the post-COVID-19 era). There were no fixed OR times in any of the examined groups that were negatively impacted by COVID-19. The percentage of the total OR time occupied by fixed OR variables in the pre-COVID-19 era was 40.6% for endoscopic operations, 41.1% for implant procedures, 29.8% for major open procedures, and 21.8% for robotic-assisted procedures.

Conclusion

A substantial portion of the total OR time includes fixed time points. Furthermore, COVID-19 did not have a negative impact on fixed OR times in a negative testing environment. Urologic OR efficiency should be maintained in the post-COVID-19 era.

Characteristics and Developments in Mesenchymal Stem Cell Therapy for COVID-19: An Update

The outbreak of coronavirus disease 2019 (COVID-19) has so far resulted in over a hundred million people being infected. COVID-19 poses a threat to human health around the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been confirmed as the pathogenic virus of COVID-19. SARS-CoV-2 belongs to the β-coronavirus family of viruses and is mainly transmitted through the respiratory tract. It has been proven that SARS-CoV-2 mainly targets angiotensin-converting enzyme II (ACE2) receptors on the surface of various cells in humans. The main clinical symptoms of COVID-19 include fever, cough, and severe acute respiratory distress syndrome (ARDS). Current evidence suggests that the damage caused by the virus may be closely related to the induction of cytokine storms in COVID-19. No specific drugs or measures have yet to be shown to cure COVID-19 completely. Cell-based approaches, primarily mesenchymal stem cells (MSCs), have been identified to have anti-inflammatory and immune functions in COVID-19. Clinical studies about using MSCs and its derivatives-exosomes for COVID-19 treatment-are under investigation. Here, we review the current progress of the biological characteristics, clinical manifestations, and cell-based treatment development for COVID-19. Providing up-to-date information on COVID-19 and potential MSC therapies will help highlight routes to prevent and treat the disease.

COVID-19 and the urological practice: changes and future perspectives

Introduction

The COVID-19 pandemic has brought great challenges to the management of urological patients. Like most surgical specialties, urology has shifted towards an emergency mentality. Currently, the beginning of the de-escalation phase of the pandemic has been observed, which will certainly pose new challenges to the urological community.

Material and methods

A non-systematic search was conducted through the Medline and Web of Science databases. The main keywords used in the search were: ‘COVID-19’, ‘SARS-CoV-2’, ‘urology’. The search included articles without time and language limitation.

Results

During the peak of the COVID-19 pandemic urological services had to focus on maintaining urgent-oncological and emergency-trauma procedures. First adapted recommendations were released at the end of March 2020. Primarily, they included information regarding the prioritization of surgical procedures. Currently, the beginning of the de-escalation phase in many countries has forced the necessity of establishing new degrees of priority for surgical interventions.

During the COVID-19 pandemic, cancellations and rescheduling significantly extend the waiting time for outpatient appointments and surgical procedures. A network of expert high-volume centres, at every level of referentiality, should guarantee the continuity of oncological care, supported with telemedicine systems.

The COVID-19 pandemic has caused a substantial decrease in clinical activity of urology residents. There also is huge potential for remote technology to address and improve education and training continuation in this field.

Conclusions

Urological care has been severely impaired by the COVID-19 pandemic. Urologists must adapt to the dynamically changing reality, prioritizing the safety and well-being of their patients and their clinic workforce.