To evaluate whether COVID-19 survivors have a higher prevalence and severity of LUTS and urinary incontinence compared to hospitalized non-COVID controls over an 8 month follow-up.

In this prospective cohort study, we included adults hospitalized between March 2022 and June 2023.We compared patients with laboratory-confirmed SARS-CoV-2 infection were compared with hospitalized controls without a history of COVID-19. LUTS were assessed using validated questionnaires at baseline, 3 months, and 8 months after discharge.

A total of 441 patients were included comprising 232 COVID-19 survivors and 209 hospitalized controls. Compared to controls, female COVID-19 survivors had greater rates of nocturia and urinary frequency at 8-month follow-up. Stress urinary incontinence was also more frequent among female COVID-19 survivors at follow-up. No significant differences were observed between groups for urgency urinary incontinence, enuresis, or post-voiding incontinence. Among men, differences were limited and less consistent.

The findings suggest that prior SARS-CoV-2 infection may be associated with a modest but clinically relevant increase in selected storage lower urinary tract symptoms (LUTS), particularly among women. The higher rates of nocturia, urinary frequency, and stress urinary incontinence in female COVID-19 survivors at 8 months may reflect persistent post-infectious effects on bladder function, potentially mediated through inflammatory, neurogenic, or urothelial mechanisms. The absence of significant differences in urgency urinary incontinence and other incontinence subtypes indicates that the effect may be symptom-specific rather than a global deterioration of lower urinary tract function. The limited and inconsistent findings in men further support a possible sex-related susceptibility. Overall, these results highlight a potential long-term urological sequela of COVID-19 in selected populations, warranting increased clinical awareness and further mechanistic and longitudinal investigations to clarify causality and underlying pathways.

COVID-19 survivors, particularly women, demonstrated a higher prevalence of selected storage LUTS during follow-up compared with hospitalized non-COVID controls. This indicates a possible association between prior SARS-CoV-2 infection and persistent urinary symptoms in selected cases, highlighting the need for targeted evaluations and further longitudinal research.