Aims To evaluate the prevalence, clinical course, and risk factors of lower urinary tract symptoms (LUTS) in patients hospitalized with COVID-19, and to assess associations with comorbidities, disease severity, and vaccination status.

Methods We conducted a prospective cohort study of adult, non-ICU patients hospitalized with confirmed COVID-19 between July 2021 and March 2022. LUTS were assessed using the IPSS, ICIQ-OAB, and ICIQ-UI SF questionnaires during hospitalization, and at one and three months post-discharge. Associations with sex, comorbidities, COVID-19 severity, and vaccination status were analyzed using multivariable logistic regression.

Results Among 168 patients (55.4% male, median age 58 years), 31.0% had moderate to severe LUTS during hospitalization, with storage symptoms predominating. Overactive bladder symptoms were present in 36.7%, and urinary incontinence in 34.5%, more frequently among women. At three months, moderate to severe LUTS declined to 21.9%, and both OAB and UI also decreased significantly. No associations were found between LUTS and comorbidities or disease severity. Fully vaccinated patients had higher odds of moderate to severe LUTS during hospitalization (adjusted OR 10.56, 95% CI 4.13–26.9), particularly those vaccinated with inactivated virus vaccines (BBIBP-CorV).

Conclusions LUTS are prevalent in the acute phase of COVID-19, especially among women, but tend to improve within three months. Unexpectedly, full vaccination— especially with inactivated virus vaccines—was associated with increased odds of moderate to severe LUTS during hospitalization. Further studies are warranted to explore the underlying mechanisms and long-term implications.

The authors have declared no competing interest.

This study did not receive any funding.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee/IRB of Hospital das Clinicas da Faculdade de Medicina da Universidade Federal de Sao Paulo (HCFMUSP) gave ethical approval for this work. Approval number: 4.765.252.

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All data produced in the present study are available upon reasonable request to the authors.