CU Medicine finds benign prostatic hyperplasia patients suffer from up to five times the risk of urological complications after COVID-19 infection
COVID-19 infection affects many extra-respiratory systems, including the urinary system. The Chinese University of Hong Kong (CUHK)’s Faculty of Medicine (CU Medicine) has conducted analysis using data from around 18,000 benign prostatic hyperplasia (BPH) patients in the local public healthcare system. Results showed that BPH patients infected with COVID-19 suffer from incidence rates of complications 2.9 to 5.31 times those of patients without COVID-19 infection, regardless of COVID-19 severity, among which the relative risk of urinary retention occurrence is the highest, followed by bacteriuria and haematuria. It is the largest cohort study in the world demonstrating that COVID-19 infection is associated with an increased incidence of BPH complications. Details of the study have been published in the Journal of Internal Medicine.
BPH is a common health problem among middle-aged and older men
The prostate is a male sex gland which produces thick fluid that forms part of the semen. BPH is a non-malignant enlargement of the prostate gland, which may gradually progress to a compression of the urethral canal. This causes obstruction of the urethra and interferes with normal urine flow. An international literature shows that prevalence of BPH is more than 80% in males older than 70.
Professor Ng Chi-fai, Tzu Leung Ho Professor of Urology, Department of Surgery, CU Medicine, said, “BPH affects not only patients’ quality of life, but its complications such as retention of urine, urinary tract infection, haematuria and bladder stone formation can also cause patients’ clinical conditions to deteriorate. Acute hospital care is needed in severe cases. As prostate epithelial cells are known from previous studies to be a target of the COVID-19 virus, we hypothesised that the risk of BPH complications increases in people infected with the virus, and so we conducted this large-scale research.”
Largest cohort study in the world to demonstrate the association between COVID-19 infection and incidence of BPH complications
CU Medicine has conducted the largest cohort study in the world demonstrating COVID-19 infection’s association with the incidence of BPH complications. Its analysis examined data from all BPH patients receiving therapeutic treatment in Hospital Authority hospitals in 2021. 8,993 BPH patients with COVID-19 infection were included in the subject group (COVID-19 group), while the same number of BPH patients without COVID-19 infection were included in the control group. The two groups demonstrated statistically significant differences in incidence rates of complications, with the COVID-19 group showing a higher incidence of urinary retention, haematuria, and urinary tract infection. COVID-19 group also had a much higher incidence of the need for combination therapy, implied worsen of their symptom after the infection. Details can be found in table 1.
Table 1: Comparison of incidence rates of complications and clinical outcomes between BPH patients with and without COVID-19 infection
Incidence rate of complication and clinical outcomes
BPH patients with COVID-19 infection (COVID-19 group,
BPH patients without COVID-19 infection (control group,
Relative risk of complication in COVID-19 group compared with control group
Retention of urine
Urinary tract infection
Addition of combination therapy due to clinical condition deterioration