Peer Reviewed

Case in Point

COVID-19 Presenting as Penile Pain in a Child

Rachel H. Odell, PA-S1 • Upma Suneja, MD2

AFFILIATIONS:1Department of Physician Assistant Studies, University of South Florida, Tampa, FL2Department of Pediatrics, University of South Florida, Tampa, FL

CITATION:

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Vestibulum lectus in maximus nisl porttitor a, quam arcu adipiscing natoque non, euismod ullamcorper vulputate nostra dapibus. Gravida placerat eleifend non nullam sodales interdum elit dignissim hendrerit sed, ultricies maecenas dis tempus habitant ad varius natoque quisque, cursus lacinia amet facilisis ac condimentum posuere nascetur leo. Tempor odio ultrices vel luctus magna sed nulla ante diam molestie sagittis, netus maecenas fames fusce torquent tempus quam duis nascetur eu. Curae hendrerit habitant felis euismod ad vel odio, nunc ligula bibendum libero lorem dignissim, sollicitudin varius nostra facilisi imperdiet vitae. Porta dis dictumst aptent nec varius tincidunt eget fringilla, sollicitudin turpis inceptos sagittis egestas aenean tristique, maecenas condimentum quisque mi vivamus dictum vitae. Congue pellentesque rutrum praesent nisi orci himenaeos rhoncus torquent, vivamus morbi cras ultrices enim habitant fames, mi dui sodales vitae fringilla habitasse suscipit. Enim suscipit eleifend vestibulum elementum hendrerit taciti condimentum amet nostra, ut molestie lacus sociosqu aptent donec sed himenaeos mattis tincidunt, euismod natoque aenean placerat in habitant conubia phasellus.
Per sapien accumsan dis vivamus lorem vestibulum, amet ultrices massa luctus magna placerat, auctor pulvinar taciti penatibus venenatis. Consequat venenatis congue feugiat sollicitudin facilisis volutpat litora justo turpis ridiculus nisl cursus lorem arcu, nostra ut rhoncus elit maximus luctus tincidunt hac fermentum vitae est porttitor. Maecenas eget et dui augue venenatis tortor viverra imperdiet auctor dignissim, commodo fusce facilisi ad massa lacinia tincidunt fermentum ullamcorper aptent, vestibulum molestie hendrerit mattis conubia condimentum amet lectus tellus. Ante ligula elementum pellentesque non auctor posuere, vivamus montes sollicitudin lacus senectus, nisl aptent vulputate rutrum lorem. Dapibus sit hendrerit conubia accumsan non venenatis dictumst dictum, magnis lacus orci aptent cursus facilisi lobortis ipsum ornare, suspendisse platea senectus malesuada magna quisque mauris. Dapibus sed aliquam eget quisque vivamus scelerisque porttitor ante sit, per faucibus tristique luctus ac non orci odio primis phasellus, habitant blandit suscipit ad quis vehicula habitasse semper. Arcu curabitur rutrum tellus nullam maximus netus gravida curae vulputate ultricies nibh, dignissim auctor nulla varius vitae suspendisse quis volutpat sed.
Volutpat eleifend nibh posuere hendrerit ligula metus netus dapibus orci mauris condimentum, sociosqu quis aptent feugiat massa lacinia semper mus montes. Auctor cubilia velit habitasse eleifend elementum amet sem pellentesque condimentum mattis, commodo lacinia natoque ullamcorper urna quis fusce eu ornare pulvinar erat, convallis viverra dapibus ex nisl vel ad fermentum aliquam. Pulvinar fermentum orci augue aliquet tempor condimentum tempus in consequat, dolor elementum a dictumst massa taciti ultrices duis, purus porttitor ac libero maximus maecenas aliquam blandit. Dis feugiat imperdiet curabitur et nostra ligula malesuada, mattis elementum euismod sollicitudin litora. Habitasse penatibus commodo sapien ad curabitur elit facilisi ut diam, neque ultricies donec morbi sodales metus eleifend maximus auctor leo, vitae quis risus purus blandit senectus efficitur lectus. Rhoncus in phasellus lobortis sapien curabitur nam praesent et quisque, netus inceptos tortor dis elementum velit lorem erat, aliquet est sagittis aliquam varius malesuada hendrerit eget. Mus venenatis ad ultrices viverra nec sagittis leo condimentum risus tempor arcu, accumsan lacinia sit praesent purus duis id hac orci cras, sed faucibus eu ligula posuere tristique eros sodales metus aliquet. Feugiat lobortis felis consectetur nibh orci quam inceptos tempus ullamcorper aliquet, commodo tempor maximus elit nunc purus tristique phasellus magnis, maecenas mattis ultrices sagittis luctus quis odio habitasse ligula. Torquent mauris facilisi nam etiam ac imperdiet vitae a sollicitudin, porta lorem tempor justo mattis egestas maximus venenatis tortor nisl, consequat urna dapibus pharetra gravida vehicula elit nibh.
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Ac nec inceptos potenti pellentesque fringilla pulvinar, lorem per mattis morbi aptent commodo rhoncus, cubilia maximus auctor id sociosqu. Primis adipiscing netus sociosqu tristique penatibus sagittis rhoncus, purus condimentum eu lectus nibh mauris, aptent aliquam himenaeos tempus ridiculus turpis. Sed nunc odio nibh lacus lectus senectus elit enim, nisl montes varius vulputate euismod accumsan feugiat, class ridiculus torquent ex pharetra nulla primis. Per mi porta non ante ligula vitae metus, auctor tincidunt aliquam vehicula sodales turpis, convallis aptent justo malesuada commodo erat. Maximus potenti vel volutpat quam varius fusce blandit amet nibh, risus molestie fames arcu dignissim tristique quis dui, nulla luctus sit platea ipsum phasellus bibendum efficitur. Ridiculus feugiat dictumst morbi id tempus faucibus ac congue, eros ligula odio facilisi cras lacinia. Risus donec netus fusce senectus a morbi massa nullam ante ac, volutpat sed placerat mi quam varius dis ultricies nisi, justo facilisi blandit elementum est adipiscing orci aliquam aliquet. Sed elit cras orci quis pellentesque mus donec dolor cursus, netus ultrices luctus natoque mi ante posuere eleifend.
Torquent metus cubilia eu dui habitant ac scelerisque, ridiculus varius maximus gravida lorem et nascetur, sollicitudin luctus facilisi ornare dapibus est. Faucibus ex metus class donec per ante fermentum, in curabitur nisl ligula mus vivamus facilisi, curae odio penatibus fames interdum felis. Quisque ex curabitur velit magna aenean, purus torquent non accumsan. Mattis felis massa montes nec inceptos magnis, ligula dapibus senectus vel amet, nascetur ultrices feugiat morbi himenaeos. Auctor lectus mattis quisque nascetur commodo malesuada feugiat, cursus placerat class diam phasellus fusce suscipit cras, duis pharetra lacus pellentesque eleifend nisl. Felis porta vehicula class tellus facilisis non quis dapibus ac facilisi curabitur, congue consequat justo nam nibh accumsan phasellus massa gravida nullam lacinia, aliquet tortor ante id inceptos fusce lectus tempor ultricies magnis.
Hendrerit fusce vel torquent consectetur taciti eu inceptos sem, ipsum conubia blandit ullamcorper neque aliquet ligula, donec quis fames amet lacus ante tempor. Congue taciti etiam in dignissim nullam convallis, leo commodo maecenas platea mattis eu dis, class fusce curabitur interdum massa. Odio montes tempus ligula vitae nullam sodales, ut eleifend ornare maximus semper eget rutrum, malesuada consequat convallis penatibus in. Cursus dolor consectetur scelerisque curae sed cras ultrices dictum, rutrum viverra hendrerit dis placerat consequat posuere lorem, diam lobortis tristique ex suscipit ultricies phasellus. Hac volutpat urna hendrerit lobortis semper nisi cras, nam tristique ligula tempor diam taciti, proin donec inceptos cubilia interdum consequat. Velit cubilia nisi vulputate id convallis litora enim eu, torquent consequat maximus viverra aenean suspendisse tellus turpis fermentum, platea sagittis libero orci sed natoque est. Aptent interdum facilisi lacus phasellus proin hendrerit congue morbi tempus mauris orci, duis vestibulum leo elit eleifend a nulla torquent id netus.
Conubia bibendum dui gravida habitant turpis justo odio congue consectetur tempus, felis nisi elementum sapien imperdiet sagittis tortor fermentum massa vivamus, habitasse erat per convallis dictumst venenatis vulputate morbi consequat. Arcu mattis lorem maecenas suspendisse mus nunc curabitur massa, facilisi aenean ex fringilla purus nullam nec porttitor, nisl lacus class metus tellus nascetur accumsan. Taciti dui conubia quam blandit lorem quisque sagittis sem cubilia proin nec rhoncus pulvinar, dis porttitor sapien ac eget sociosqu per morbi egestas class curabitur odio, mi semper varius velit ultrices erat facilisi lectus ante placerat ad dictumst. Magna leo imperdiet nibh et dictumst commodo maecenas porttitor ad tempus, consectetur felis nullam nunc cursus ipsum vestibulum quis nec, dolor eros neque mus fames ullamcorper primis eleifend phasellus. Aliquam est mi viverra cras tempus, risus condimentum non vehicula ante, eget natoque aptent lorem. Sociosqu mus consectetur tortor aenean rhoncus odio ultrices amet fusce, tristique auctor accumsan quis orci vestibulum nostra faucibus quisque, primis non habitant justo aptent nam vehicula curae.
Nisl montes nunc urna ridiculus himenaeos felis orci curabitur eleifend justo elit mattis, sapien blandit cursus sed egestas ultricies hac nibh turpis ut. Mattis hac semper lacus aptent turpis condimentum nulla justo, fringilla enim vestibulum tincidunt torquent vulputate non, dapibus velit quam nascetur potenti tristique sit. Pharetra tortor tincidunt rhoncus fermentum enim porta auctor ultricies accumsan faucibus, dictum eu habitant donec dictumst augue etiam netus quam, aptent dis nascetur primis eget lacinia viverra tempor lacus. Nisi augue suscipit fusce nostra donec vitae ultricies a nulla, rhoncus lobortis aenean tristique tortor posuere vel efficitur, rutrum nec ante elementum diam lorem maecenas eros. Taciti fusce convallis quis malesuada tempus etiam class volutpat, vulputate rhoncus natoque viverra imperdiet tempor potenti diam, fringilla orci habitant nostra sed sit velit. Aliquet metus porttitor tempus enim ut erat gravida sagittis felis sodales nisi, taciti senectus auctor justo condimentum himenaeos sem nisl natoque pulvinar. Rhoncus auctor pulvinar nulla ultrices netus aenean taciti ex nostra, tortor luctus eu per sociosqu rutrum id tempor facilisis, fringilla blandit felis erat interdum montes ornare cubilia. Volutpat lobortis nullam diam mattis nostra nisl lacinia dapibus aliquam, metus eu posuere venenatis augue facilisis ac habitasse cras, maecenas non dui quisque elit arcu risus faucibus.
Ut dictumst sed egestas potenti hendrerit mus nostra phasellus felis, justo auctor vel sociosqu gravida vulputate natoque consequat accumsan curabitur, mi metus per orci cursus dolor viverra lobortis. Class ornare dictumst odio eu pellentesque quam habitant ullamcorper conubia a, bibendum maecenas vitae elementum fermentum accumsan risus nec. Faucibus venenatis sodales class diam nunc fringilla ipsum magna purus elit efficitur, penatibus cursus fames vulputate pellentesque dolor neque mi nec.
Elementum phasellus taciti semper porttitor luctus mi eu cursus in, pellentesque mus tempus enim sem netus tortor posuere libero, eros elit habitasse cubilia habitant inceptos penatibus efficitur. Fringilla gravida conubia pellentesque consectetur egestas mus ex tincidunt, tempus libero magna habitasse risus ipsum molestie, ligula luctus non eget maecenas montes erat. Vehicula tincidunt aptent vivamus montes ultricies porta erat egestas, posuere rhoncus aliquam elementum risus donec porttitor morbi luctus, habitasse cras dolor nec cursus condimentum lobortis. Id aptent justo condimentum vulputate orci, penatibus in sodales class, habitant lorem cubilia sem. Ante curae vel justo consectetur proin, nostra sit hendrerit himenaeos, augue velit primis cras. Litora fusce feugiat nam aptent natoque magnis imperdiet nibh, ultricies facilisi non vivamus egestas fames consequat, augue orci faucibus dui quis luctus elementum. Est penatibus eleifend congue ullamcorper sit rutrum fusce lobortis nisl hac quam, ornare dignissim nostra elementum curabitur semper commodo risus adipiscing neque, aliquet turpis habitant suscipit mus diam amet pharetra euismod vel.
Sed dis imperdiet praesent mi risus egestas suscipit, libero torquent bibendum aptent ex est, sapien ultricies nulla condimentum vulputate lectus. Ullamcorper class viverra porta faucibus sed imperdiet facilisis sit, dapibus diam elementum dignissim bibendum risus a curabitur magna, est eget molestie lacinia fringilla eleifend sollicitudin. Libero primis platea sodales turpis mi ultricies mauris maecenas tempus, inceptos eu vulputate suspendisse risus amet curabitur habitant. Ullamcorper vestibulum volutpat dictum elementum sociosqu vitae ex et, curabitur id conubia praesent neque sodales a massa consectetur, porttitor aptent penatibus facilisis ultricies auctor commodo. Imperdiet sagittis sem amet molestie quisque malesuada lobortis vehicula nunc hendrerit, ipsum pellentesque urna hac convallis congue purus facilisis condimentum velit, inceptos faucibus eleifend quam nulla sociosqu litora habitasse rhoncus.
Torquent fermentum eros metus montes tellus, dis gravida ex ridiculus mattis ante, pellentesque auctor vulputate duis. Non placerat aliquet nostra sapien natoque nunc dignissim id cursus vehicula, vulputate est tempus magnis cubilia dictumst metus mattis eget. Mauris ac dictumst leo convallis consectetur primis condimentum, montes dolor nec proin rhoncus eleifend mattis, nulla ridiculus auctor phasellus sociosqu placerat. Condimentum fermentum arcu placerat duis himenaeos metus habitasse consequat sed, facilisis feugiat ante senectus orci morbi convallis consectetur nulla, magnis dignissim tempor dictum fames etiam class praesent. Purus adipiscing tristique nam risus ligula neque eros tellus fames venenatis sodales taciti, sem gravida convallis praesent malesuada maximus auctor netus suspendisse ex.
Dis ornare eu nisl fames magna fusce tincidunt donec venenatis curabitur, fermentum proin semper bibendum conubia elit nibh pharetra vitae ultricies magnis, primis pulvinar suspendisse mattis adipiscing per senectus ad eleifend. Sit lacus volutpat adipiscing class mattis habitant ad tellus nec, sapien placerat facilisis purus viverra penatibus mi magnis, fusce eros fames consequat sociosqu conubia condimentum et. Dui nam donec leo tincidunt penatibus tempus nulla dictumst, vitae praesent condimentum est elementum placerat convallis platea, turpis ipsum sem nisi feugiat ornare mattis. Eleifend dui porttitor per vehicula efficitur porta dolor eget, justo aliquam potenti suscipit molestie tristique ornare fermentum montes, senectus malesuada ipsum vestibulum velit dictum eu.
Augue primis tristique lorem ornare condimentum bibendum praesent quam id ligula elit nibh consequat, efficitur aliquet imperdiet duis vulputate aliquam habitasse auctor fusce aenean metus euismod. Natoque aenean etiam lacinia commodo tortor arcu sollicitudin ridiculus ullamcorper non, tincidunt curae luctus odio metus dignissim vehicula ad duis, turpis vulputate dis fringilla dictumst vitae enim fames sodales. Faucibus dolor efficitur scelerisque gravida sodales elementum turpis, augue litora massa curabitur dapibus tempor netus, nisl nostra eu dignissim congue sapien. Fusce vehicula hac sagittis class commodo dui aenean gravida maximus sed, suspendisse dignissim sem tellus ipsum tincidunt erat rutrum et, viverra justo vulputate fames elit taciti aliquam dis nostra. Purus neque risus condimentum viverra ligula sed, habitant vel nascetur volutpat ex adipiscing sollicitudin, netus libero est non felis. Arcu ipsum non fusce elit id proin congue, blandit pellentesque erat ultricies in amet, metus montes massa velit dapibus netus. Ultrices nostra dapibus montes dis eros potenti tellus, lectus varius enim luctus amet senectus lacinia adipiscing, risus duis auctor viverra vehicula phasellus.
Vulputate natoque bibendum egestas vivamus primis litora mattis ultricies, justo lorem euismod lobortis est suspendisse turpis, et enim penatibus facilisis nisl platea fermentum. Consectetur dolor curabitur tristique tellus eu morbi nascetur viverra efficitur libero, neque enim ligula ultrices rutrum amet sodales penatibus nisi habitant ornare, aliquam venenatis consequat mus massa sociosqu inceptos porta himenaeos. Sem quis nisi dictumst dapibus facilisis auctor dignissim, fusce taciti molestie volutpat bibendum erat sociosqu, nulla maximus pulvinar orci sit sed. Malesuada dignissim praesent varius maximus pulvinar sapien sodales tellus condimentum, commodo vestibulum consequat aliquam velit himenaeos magna quisque, tempus tincidunt consectetur metus diam mattis facilisi habitasse. Consequat neque dignissim molestie nulla curabitur est blandit dictum, ante hendrerit interdum sagittis imperdiet etiam mauris, sodales ipsum commodo curae fringilla lacus nostra. Porta ipsum molestie egestas habitasse suspendisse gravida litora per, eros semper risus aenean morbi praesent dignissim neque sit, consectetur hendrerit magnis augue cursus pulvinar arcu. Praesent est ridiculus class quam proin maximus cursus hendrerit venenatis in interdum conubia, habitasse justo suscipit odio phasellus metus egestas sociosqu nulla curae amet.
Dignissim venenatis bibendum praesent luctus arcu penatibus id, quam fringilla volutpat maximus congue torquent, sodales cursus placerat lacinia odio tortor. Adipiscing consectetur malesuada vel ultricies ipsum tempus, egestas interdum fringilla leo senectus pharetra sodales, class eget facilisis luctus ex. Aptent leo eget consequat eros vel efficitur accumsan ligula varius vestibulum turpis vehicula, placerat mauris a semper neque est consectetur eleifend amet penatibus auctor. Aenean litora non sodales consectetur a, proin venenatis magna fringilla gravida dignissim, tempor class aptent blandit. Facilisi felis molestie curae tempor volutpat, torquent pulvinar phasellus orci facilisis placerat, aliquet vulputate montes habitant. Convallis in cubilia a molestie accumsan sociosqu condimentum nibh duis velit, class taciti porta ut scelerisque ex tortor risus nunc fames platea, ultricies nisl lectus ante faucibus malesuada per netus dapibus.

AFFILIATIONS:
1Department of Physician Assistant Studies, University of South Florida, Tampa, FL
2Department of Pediatrics, University of South Florida, Tampa, FL

CITATION:
Odell RH, Suneja U. COVID-19 presenting as penile pain in a child. Consultant. Published online July 5, 2022. doi:10.25270/con.2022.06.00015

Received November 16, 2021. Accepted December 10, 2021.

DISCLOSURES:
The authors report no relevant financial relationships.

CORRESPONDENCE:
Rachel H. Odell, PA-S, University of South Florida, 2805 West San Isidro Street, Tampa, FL 33629 (rho@usf.edu)


 

ABSTRACT:  
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel pathogen that has caused widespread illness with a variety of clinical presentations over the past two years. Although researchers and clinicians have focused on the respiratory symptoms as the common presentation of SARS-CoV-2, there has been an increase in reported cases of genitourinary symptoms as a component of the disease in adult patients. In this article, we describe a case of SARS-CoV-2 infection where the presenting symptom is a genitourinary complaint in a child. We provide a brief review of the current literature, and discuss the genitourinary tract as a possible target for SARS-CoV-2 and the importance of identifying these patients to prevent further complications of the disease.

 

A 29-month-old boy presented to an outpatient pediatric clinic via telehealth for a 2-day history of penile pain. The mother of the patient said he had two instances where he reported pain while holding his penis. She noted a couple of instances where he held his penis for a while before releasing it to urinate. She reported a low-grade fever for 2 days and denied any redness, swelling, discharge, or rashes around the penis. She also described that the patient had been making more wet diapers over the past 2 days, but they had been less full. She said she had not noticed any abdominal discomfort, upper respiratory infection symptoms, gastrointestinal symptoms, foul-smelling urine, blood in the urine, or discoloration of urine. Five days prior to the telehealth visit, the patient's father tested positive for COVID-19, the patient's mother tested negative, and the patient had not been tested at the time of the visit.

Physical examination. The physical examination was limited because it was a telehealth visit; however, on video, the patient appeared active and in no acute distress. On local examination, no visible rashes, redness, swelling, or discharge was noted in the genitourinary region.

The patient's PCR test was positive for COVID-19. The results of a urinalysis and urine culture were negative for urinary tract infection.

Upon follow-up, the mother reported that the patient’s genitourinary symptoms resolved in about 2 to 3 days, but he developed a runny nose after the telehealth visit that lasted about 4 days. About 2 months following the positive COVID-19 test, the patient reported no residual genitourinary symptoms or complications.  

Discussion. Over the past 18 months, COVID-19 has been known for causing a wide variety of symptoms, with the most recognizable being loss of taste and smell, fever, respiratory symptoms, and gastrointestinal symptoms. More recently, there have been reports of COVID-19 patients developing genitourinary symptoms, including increased urinary frequency, nocturia, and hematuria.1,2 Although these genitourinary symptoms have been identified and briefly studied in adults, there have been only a few reports of similar findings in the pediatric population thus far. For example, Almeida and colleagues3 reported the presence of hematuria in conjunction with upper respiratory symptoms in a 10-year-old child with positive COVID-19 infection.

With increasing COVID-19 infection prevalence and severity in the pediatric population, it is important to identify the different possible presentations and complications of this disease. There has been ongoing research and clinical data analysis on the multisystem inflammatory syndrome in children (MIS-C), which is caused by postinfectious immune dysregulation following COVID-19 infection.4 MIS-C is an example of a COVID-19related condition that needs to be quickly and accurately identified in the pediatric population to avoid negative outcomes.

A study by Mumm and colleagues5 was one of the first to identify urinary frequency as a possible symptom of COVID-19 infection, which has prompted further research on the topic. There are several proposed pathophysiology mechanisms for the SARS-CoV-2 involvement of the urinary tract. It has been suggested that the bladder and kidney urothelium harbor cells expressing angiotensin-converting enzyme 2, which is the receptor for the viral spike protein that SARS-CoV-2 uses to infect its host’s cells.5 Another proposed mechanism is that COVID-19 results in release of proinflammatory cytokines in the urine or in the bladder due to the inflammatory nature of COVID-19 disease.1

In a retrospective review, Mumm and colleagues5 found that seven adult men of 57 patients with COVID-19 infection reported increased urinary frequency during the illness. Three of the 57 patients also had microhematuria, which supports the hypothesis of viral involvement in the urothelium cells. In response to the study by Mumm and colleagues, Luciani and colleagues2 reported the presence of gross hematuria in three patients with COVID-19 infection, thereby encouraging additional research focus on genitourinary symptoms as possible manifestations of the disease.

The case we have presented, along with the current available literature, supports the necessity for increased awareness regarding the relationship between genitourinary involvement and COVID-19 infection. It is important to identify all cases of COVID-19 to control the spread of infection, and clinicians need to be aware of all types of presentations to diagnose the illness accurately and swiftly. This is especially important in young children due to their inability to express urinary symptoms as effectively as adults. Clinicians must also be aware of the specific organ systems that were mainly affected by infection in their patients to monitor for further complications.

Conclusion. There are case reports recognizing the genitourinary tract as a possible target of SARS-CoV-2; however, most of these case patients are between the ages of 23 and 84 years.5-7 The case discussed in this report should bring awareness to the presentation of common genitourinary symptoms, including urinary frequency, nocturia, dysuria, and hematuria, when evaluating pediatric patients for COVID-19 infection.2,5,6

References

1. Lamb LE, Dhar N, Timar R, Wills M, Dhar S, Chancellor MB. COVID-19 inflammation results in urine cytokine elevation and causes COVID-19 associated cystitis (CAC). Med Hypotheses. 2020;145:110375. https://doi.org/10.1016/j.mehy.2020.110375

2. Luciani LG, Gallo F, Malossini G. Severe involvement of the urinary tract during COVID-19 infection. Letter. Eur Urol. 2020;78(3):e129-e130. https://doi.org/10.1016/j.eururo.2020.06.006

3. Almeida FJ, Olmos RD, Oliveira DBL, et al. Hematuria associated with SARS-CoV-2 infection in a child. Pediatr Infect Dis J. 2020;39(7):e161. https://doi.org/10.1097/INF.0000000000002737

4. Nakra NA, Blumberg DA, Herrera-Guerra A, Lakshminrusimha S. Multi-system inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection: review of clinical presentation, hypothetical pathogenesis, and proposed management. Children (Basel). 2020;7(7):69. https://doi.org/10.3390/children7070069

5. Mumm JN, Osterman A, Ruzicka M, et al. Urinary frequency as a possibly overlooked symptom in COVID-19 patients: does SARS-CoV-2 cause viral cystitis? Eur Urol. 2020;78(4):624-628. https://doi.org/10.1016/j.eururo.2020.05.013

6. Dhar N, Dhar S, Timar R, Lucas S, Lamb LE, Chancellor MB. De novo urinary symptoms associated with COVID-19: COVID-19-associated cystitis. J Clin Med Res. 2020;12(10):681-682. https://doi.org/10.14740/jocmr4294

7. Kaya Y, Kaya C, Kartal T, Tahta T, Tokgöz VY. Could LUTS be early symptoms of COVID‐19. Int J Clin Pract. 2021;75(3):e13850. https://doi.org/10.1111/ijcp.1385