# COVID-19-Associated Cystitis: De Novo Urinary Urgency Following SARS-CoV-2

## TL;DR

This paper reports a case of bladder symptoms following recovery from COVID-19, highlighting a new condition called COVID-associated cystitis.

## Contribution

The paper introduces and contextualizes the clinical entity of COVID-associated cystitis (CAC) and its treatment implications.

## Key findings

- A 71-year-old woman developed persistent urinary urgency after recovering from COVID-19.
- CAC symptoms overlap with overactive bladder and interstitial cystitis, suggesting shared mechanisms.
- CAC is distinct from bacterial cystitis and can be managed using overactive bladder treatment frameworks.

## Abstract

COVID-19 is widely recognized as a systemic disease with pulmonary, cardiovascular, and neurologic manifestations, yet growing evidence highlights the genitourinary tract as another important site of involvement. A distinct clinical entity, COVID-associated-cystitis (CAC), has been described in which patients develop de novo or worsening lower urinary tract symptoms (LUTS), such as urgency, frequency, and nocturia, without bacterial infection. This case report describes a 71-year-old woman who developed persistent urinary urgency following recovery from COVID-19, successfully treated with oxybutynin. The case is contextualized within the expanding literature on CAC, including evidence from biomarker studies, mechanistic analyses, and large cohort investigations. Emerging data support a pathophysiologic role for both inflammatory cytokine release and viral receptor expression in the bladder, with symptom overlap between CAC, overactive bladder (OAB), and interstitial cystitis. Recognition of CAC is clinically significant, preventing misdiagnosis as bacterial cystitis and guiding management using established OAB frameworks. The case underscores the importance of considering genitourinary sequelae of COVID-19 and contributes to the growing discussion on long COVID and bladder health.