Review Article
Pediatric urology amidst SARS-CoV-2 pandemic: Building the future with current knowledge

https://doi.org/10.1016/j.jpedsurg.2021.01.017Get rights and content

Highlights

  • First article to discuss ethical resource allocation amidst scarcity within pediatric urology.

  • Development and implementation of a scarce resource allocation team (SRAT) can be executed using the quality improvement plan-do-study-act model.

  • Surgical pediatric urology cases can be triaged appropriately and ethically using the pediatric Medically-Necessary, time-sensitive (pMeNTS) scoring system.

Abstract

Introduction

The COVID-19 pandemic has ripped around the globe, stolen family members and forced healthcare systems to operate under an unprecedented strain. As of December 2020, 74.7 million people have contracted COVID-19 worldwide and although vaccine distribution has commenced, a recent rise in cases suggest that the pandemic is far from over.

Methods

This piece explores how COVID-19 has explicitly impacted the field of pediatric urology and its patients with a focus on vulnerable subpopulations.

Results

Various medical and surgical associations have published guidelines in reaction to the initial onset of the pandemic in early 2020.

Discussion and Conclusion

As the number of patients with COVID-19 increases, long-term recovery and future preparedness are imperative and should be cognizant of patient subpopulations that have been subject to disproportionate morbidity and mortality burden. Development of a dedicated response team would aid in achieving preparedness by drafting and implementing plans for resource allocation during scarcity, including logistic and ethical considerations of vaccine distribution.

Level of evidence

III

Keywords

Pediatric urology
SARS-CoV-2
COVID-19
Ethics
Social justice
Nonmaleficence

Abbreviations

AAP
American Academy of Pediatrics
ACIP
Advisory Committee on Immunization Practices
ACS
American College of Surgeons
AHA
American Hospital Association
AUA
American Urological Association
BAPU
British Association of Paediatric Urologists
CKD
chronic kidney disease
COVID-19
Coronavirus Disease
ESAS
Elective Surgery Acuity Scale
ESPU
European Society of Paediatric Urology
EUA
Emergency Use Authorization
EUA
European Urological Association
FDA
Food and Drug Administration
MeNTS
Medically-Necessary, Time-Sensitive procedures
MIS
minimally invasive surgery
pMeNTS
Pediatric Medically-Necessary, Time-Sensitive procedures
SARS
severe acute respiratory syndrome
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
SRAT
Scarce Resource Allocation Team

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