Hypothesis / aims of study
The COVID-19 pandemic has had a significant impact on mortality trends and health outcomes worldwide. In Spain, the pandemic has affected mortality rates and health statistics. The aim of this study was to analyze the impact of the COVID-19 pandemic on mortality from LUTS and urological tumors in Spain.
Study design, materials and methods
This retrospective cohort study used data provided by the National Institute of Statistics. Causes of death were recoded by LUTS and urological tumors, including upper urinary tract urothelial cell carcinoma, renal cell cancer, bladder cancer, and prostate cancer. Mortality rates for LUTS and urological tumors in 2019, 2020, and 2021 were analyzed using descriptive statistics to analyze the frequency and proportion of deaths by gender, age, and Autonomous Communities (AC). Logistic regression models were used to estimate the variables associated with mortality from LUTS and urological tumors.
Results
In 2019, 6.9% of 418,703 deaths were from LUTS and urological tumors; in 2020, 6.2% of 493,776 deaths, and in 2021, 7.0% of 450,744 deaths. During the peak of the pandemic in 2020, there was a 10.2% decrease (p<0.05) in mortality from LUTS and urological tumors compared to 2019. However, in 2021, mortality from LUTS and urological tumors increased and even surpassed pre-pandemic levels, particularly for LUTS. Logistic regression analysis showed that male gender, age, and certain AC (i.e. Canarias, Cantabria, Asturias, and Murcia) were associated with higher mortality rates from LUTS and urological tumors. The risk of mortality from LUTS and urological tumors increased with age, with the highest mortality rates observed in individuals over the age of 70. Patients of non-Spanish nationality had lower mortality rates from COVID-19 (p=0.007) and municipalities with less than 10,000 inhabitants also had lower mortality rates (p<0.001).
Interpretation of results
The COVID-19 pandemic has had a significant impact on mortality from LUTS and urological tumors in Spain. During the peak of the pandemic, mortality from LUTS and urological tumors decreased, likely due to underdiagnosis. However, in 2021, mortality from LUTS and urological tumors increased and even surpassed pre-pandemic levels, particularly for LUTS. Delayed diagnosis and treatment during the pandemic may have contributed to this increase. Our analysis also showed that male gender, age, and certain AC were associated with higher mortality rates from LUTS and urological tumors. These findings highlight the need for targeted interventions to improve the diagnosis and treatment of LUTS and urological tumors, particularly for high-risk groups.