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Minerva Urologica e Nefrologica 2020 June;72(3):376-83

DOI: 10.23736/S0393-2249.20.03861-8


language: English

Clinical pathways for urology patients during the COVID-19 pandemic

Alchiede SIMONATO 1, 2, Gianluca GIANNARINI 3, Alberto ABRATE 1, Riccardo BARTOLETTI 4, Alessandro CRESTANI 5, Cosimo DE NUNZIO 6, Andrea GREGORI 7, Giovanni LIGUORI 8, Giacomo NOVARA 9, Nicola PAVAN 8, Carlo TROMBETTA 8, Andrea TUBARO 6, Francesco PORPIGLIA 10, Vincenzo FICARRA 11 , on behalf of the Research Urology Network (RUN)

1 Section of Urology, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy; 2 Unit of Urology, Department of Surgery, S. Croce e Carle Hospital, Cuneo, Italy; 3 Unit of Urology, Santa Maria della Misericordia Academic Medical Center, Udine, Italy; 4 Unit of Urology, Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy; 5 Unit of Urology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; 6 Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy; 7 Unit of Urology, ASST Fatebenefratelli-Sacco, Sacco Hospital, Milan, Italy; 8 Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy; 9 Department of Surgery, Oncology, and Gastroenterology, Urology Clinic, University of Padua, Padua, Italy; 10 Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy; 11 Section of Urology, Gaetano Barresi Department of Human and Pediatric Pathology, University of Messina, Messina, Italy

The public health emergency caused by the Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a significant reallocation of health resources with a consequent reorganization of the clinical activities also in several urological centers. A panel of Italian urologists has agreed on a set of recommendations on pathways of pre-, intra- and post-operative care for urological patients undergoing urgent procedures or non-deferrable oncological interventions during the COVID-19 pandemic. Simplification of the diagnostic and staging pathway has to be prioritized in order to reduce hospital visits and consequently the risk of contagion. In absence of strict uniform regulations that impose the implementation of nasopharyngeal swabs, we recommend that an accurate triage for COVID-19 symptoms be performed both by telephone at home before hospitalization and at the time of hospitalization. We recommend that during hospital stay patients should be provided with as many instructions as possible to facilitate their return to, and stay at, home. Patients should be discharged under stable good conditions in order to minimize the risk of readmission. It is advisable to reduce or reschedule post-discharge controls and implement an adequate system of communication for telemonitoring discharged patients.

KEY WORDS: Coronavirus; COVID-19; Clinical pandemic; Urology; Practice guideline; Clinical pathways; Telemedicine

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