There is a link between COVID-19 and symptoms that resemble overactive bladder (OAB). Research notes that COVID-19 appears to worsen existing OAB or causes new symptoms, such as urinating more often or urgently.

Scientists are not sure what exactly causes these symptoms, so they do not always refer to them as OAB.

A 2022 study calls this condition COVID-19-associated cystitis (CAC) due to a theory that inflammation is the cause. Cystitis refers to inflammation of the bladder. Other sources refer to the symptoms as COVID-19-related lower urinary tract symptoms (LUTS).

COVID-19-related LUTS tend to be worse in people with more severe cases of COVID-19. Not everyone with COVID-19 gets urinary symptoms, though.

In this article, we will explain the link between urinary symptoms and COVID-19, as well as the symptoms a person may experience. We will also look at how doctors may diagnose and treat them.

Coronavirus data

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on COVID-19.

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Research suggests there is a link between COVID-19 and LUTS.

Usually, COVID-19 affects the respiratory system, causing symptoms in the airways and lungs. However, COVID-19 has the potential to be a multisystem illness, meaning it can affect more than one system in the body at once.

According to a 2022 study, COVID-19 can affect the:

  • gastrointestinal system, which is responsible for digestion
  • cardiovascular system, which pumps blood around the body
  • central nervous system, which includes the nerves and brain
  • urinary system, which includes the bladder and urinary tract

It is unclear how many people have LUTS, but the researchers in this study found that the prevalence of urinary symptoms was “relatively high.”

Another 2022 study found that those who had COVID-19 with symptoms had three times the risk of developing urinary symptoms than people who did not have COVID-19.

The risk of new urinary symptoms was also high in people who had COVID-19 with no symptoms — two times higher than people with no COVID-19.

Scientists are still learning about how COVID-19 affects the body. However, they know that the kidneys and bladder are responsible for removing waste from the body, and this can include alive or dead viruses.

Previous studies have found viral RNA in the urine of people with COVID-19, although this does not always correlate to symptoms.

It may be that the virus directly infects the urinary tract, causing symptoms, or that the immune response to the virus creates inflammation.

Inflammation of the bladder can lead to cystitis, which can make a person need to urinate more urgently or more often. Inflammation of the prostate gland may lead to similar symptoms.

LUTS are more common in:

  • males
  • older adults
  • people with severe COVID-19

As males and older adults are more susceptible to COVID-19 in general, it seems that LUTS may be part of an overall higher burden of illness in these groups.

Severe COVID-19 can also damage the kidneys, which may prevent them from working as they should. Scientists theorize this could be a factor in post-COVID-19 LUTS, but more research is necessary to prove this.

If COVID-19 affects a person’s urinary tract, they may need to urinate:

  • more urgently
  • more frequently
  • at night, which may disturb their sleep

In some cases, people have also reported passing blood or pus in their urine.

LUTS do not always appear when a person has COVID-19. Some people develop them weeks or months after the infection is gone, as part of a condition known as long COVID.

Most people recover from COVID-19 in around 1 week. For some, LUTS may also improve around this time. However, some people continue experiencing symptoms for longer.

It is unclear how often this happens with urinary symptoms, but generally, people with long COVID symptoms tend to gradually improve over time. It is uncertain if everyone with long COVID will fully recover, though.

A 2022 study emphasizes the need for more research into whether COVID-19-related LUTS are reversible.

While there is a link between COVID-19 and new LUTS, the virus that causes COVID-19, SARS-CoV-2, may not be the direct cause in all cases.

For example, stress can make existing LUTS worse, and there are many aspects of living through a pandemic that might cause stress.

A 2021 study in Italy found that women with OAB had significantly worse symptoms 4 weeks after authorities introduced social distancing than they did before, suggesting that stress affected the severity.

Additionally, people can develop secondary bacterial infections after having a viral infection. This is not very common in people with COVID-19, but research suggests that, when it does happen, UTIs are one of the most common infection types.

Learn more about the potential causes of OAB.

Before visiting a medical facility, people who are unsure if they have COVID-19 should follow local guidance for getting tested. If they test positive, they should stay at home and follow the advice of their local health authority.

If a person tests negative or has new or worsened urinary symptoms after the infection is gone, they should contact a doctor.

The doctor will start by asking questions about a person’s symptoms and medical history. They may also perform a physical examination to look for signs of pain or infection.

There is no single test for OAB or CAC, so a doctor may recommend tests that look for an underlying cause. This could include:

  • urine tests
  • bladder scans
  • blood tests
  • less commonly, a cystoscopy or urodynamic testing

A doctor may also ask a person to keep a bladder diary for a few weeks. This records:

  • the amount a person drinks
  • the frequency and amount a person urinates
  • symptoms such as feelings of urgency or urine leakage

This can help a doctor understand the symptoms in more detail.

There are no specific treatments for COVID-19-related urinary symptoms. Doctors may try existing treatments instead. The options they recommend will depend on a person’s situation.

Current COVID-19 case

If a person still has COVID-19, their symptoms may be a direct result of SARS-CoV-2, or the coronavirus. They may improve on their own as the infection runs its course.

If a person is at risk of serious COVID-19 or has severe symptoms, they may need antiviral drugs. Antibiotics will only help if a person has a bacterial infection. A doctor can determine if this is the case with a urine test.

Previous COVID-19 case

If LUTS appear or persist after a person has COVID-19, doctors may suggest:

  • Medications: If a person has cystitis, medications that reduce inflammation may help. For OAB, there are specific medications that may help the bladder hold more urine, or reduce the need to urinate at night.
  • Lifestyle changes: People can manage LUTS by changing some habits. For example, it may help to avoid things that make them urinate more, such as caffeine and alcohol. Scheduled urination and similar techniques may also prevent urgency.
  • Exercises: Exercises that strengthen the pelvic floor and bladder muscles may help a person gain more control. This includes Kegel exercises.
  • Procedures: People with OAB due to dysfunction of the nerves around the bladder may benefit from nerve stimulation or bladder Botox.
  • Vaccination: A 2021 study that has not yet undergone peer review found that COVID-19 vaccination led to improvements in long COVID symptoms after 120 days.

However, it is worth noting that there is no research on whether these treatments specifically help people with COVID-19-related symptoms yet.

Research suggests there is a link between COVID-19 and symptoms that resemble OAB.

People with COVID-19 appear to be more likely to develop LUTS than those who have not had a SARS-CoV-2 infection, even if they had no symptoms. People with pre-existing OAB may also find that their symptoms worsen.

Research into the relationship and potential treatments for COVID-19-related LUTS is still ongoing. Doctors may suggest trying existing therapies to address the potential underlying causes or to reduce symptoms.