World Journal of Urology

https://doi.org/10.1007/s00345-020-03207-x

LETTER TO THE EDITOR

COVID‑19 outbreak situation and its psychological impact

among surgeons in training in France
Maher Abdessater1 · Morgan Rouprêt1 · Vincent Misrai2 · Ugo Pinar1 · Xavier Matillon3 · Bastien Gondran‑Tellier4 ·
Lucas Freton5 · Maxime Vallée6 · Inès Dominique7 · Margaux Felber1 · Zine‑Eddine Khene5 · Edouard Fortier8 ·
François Lannes4 · Clément Michiels9 · Tristan Grevez10 · Nicolas Szabla11 · Florian Bardet12 · Kevin Kaulanjan13 ·
Emilien Seizilles de Mazancourt3 · Guillaume Ploussard14 · Benjamin Pradere10,15

Received: 7 April 2020 / Accepted: 8 April 2020

© Springer-Verlag GmbH Germany, part of Springer Nature 2020, corrected publication 2020

Dear Editor, Despite all the widespread recommendations given by the

national authorities, only 43.3% felt to have sufficient per-
The COVID-19 outbreak is a challenge for health care work- sonal protective equipment (PPE). According to this condi-
ers (HCW). Young surgeons have switched immediately tion, 92% of the participants reported to be stressed, with a
their daily practice into eclectic tasks (e.g., nursing patients medium-to-high level of stress in 56.5% of the cases. Moreo-
in ICU, examining COVID patients…). These individu- ver, more than 60% of responders noted that this health crisis
als represent one of the most at-risk population to become was impacting the quality of their work.
infected and potentially COVID-19 spillers. Importantly, the increase of stress was significantly more
Only 2 weeks after the beginning of COVID-19 lock- frequent for those who were in a high epidemic region, when
down, a self-administered questionnaire was e-mailed to the COVID-19 patients were in their department and when they
members of the French Association of Urologists in Training already had a personal past medical history of respiratory
(AFUF), who have been routinely evaluated concerning their disease. The pandemic was more likely to have a negative
stress [1, 2]. impact on the quality of work for the most experienced
In less than 72 h, 275 (59.6%) members replied to the urologists in training and when COVID-19 patients were
questionnaire (see Table 1). Overall 76.7% had COVID-19 hospitalized in their own urology department.
patients in their department, 61.5% judged themselves una- Moreover, 83.3% of the responders judged that the
ble to treat their symptoms and 75.3% did not receive any COVID crisis had a negative impact on their urological
updated guidelines on respiratory tract infection treatment. training, knowing that overall satisfaction with urology

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* Morgan Rouprêt Department of Urology, Montpellier University Hospital,
[email protected] Montpellier, France
9
1 Department of Urology, Bordeaux University Hospital,
Sorbonne Université, GRC n°5, Predictive Onco-Urology,
Bordeaux, France
Ap-Hp, Hôpital Pitié-Salpêtrière, Urology, 75013 Paris,
10
France Department of Urology, CHRU Tours, Francois Rabelais
2 University, Tours, France
Clinique Pasteur, 31300 Toulouse, France
11
3 Department of Urology and Transplantation, Caen University
Department of Urology and Transplantation, Edouard Herriot
Hospital, Caen, France
Hospital, Hospices Civils de Lyon, Lyon, France
12
4 Department of Urology, Dijon University Hospital, Dijon,
Department of Urology, La Conception University Hospital,
France
Assistance-Publique Marseille, Marseille, France
13
5 Department of Urology, CHU Pointe à Pitre, Guadeloupe,
Department of Urology, University Hospital of Rennes,
France
Rennes, France
14
6 Department of Urology, Ramsay Santé, Clinique la Croix du
Department of Urology, Poitiers University Hospital,
Sud, Quint Fonsegrives, France
Poitiers, France
15
7 Department of Urology, Comprehensive Cancer Center,
Department of Urology, Groupe Hospitalier Diaconesses
Medical University of Vienna, Vienna, Austria
Croix Saint-Simon, Paris, France

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 World Journal of Urology

Table 1  Responders characteristics training. Hence, it is important to implement medical and

N = 275 psychological reinforcement in every urological team who is
involved in the management of COVID-19 patients.
Age in years, mean (SD) 29.5 (0.47) During the crisis, it is important to keep in mind that young
Female gender, n (%) 90 (32.7) urologists in high epidemic regions require a particular atten-
Medical history, n (%) tion. COVID-19 crisis seems to be a major stressor for urolo-
 None 244 (88.7) gists in training and could lead to poorer caregiver mental
 Respiratory 20 (7.3) health.
 Other 11 (4) Managing the psychosocial well-being during this time
Psychiatry history, n (%) 3 (1.1) appears to be of utmost importance not only for coronavirus
Smoker, n (%) 54 (19.6) but also in the perspective of future similar pandemic crisis.
Experience, n (%)
 1st year-resident 21 (7.6)
 2nd year-resident 33 (12)
 3rd year-resident 30 (10.9) Author contributions  MA: protocol/project development, data analysis,
 4th year-resident 31 (11.3) manuscript writing/editing. MR: protocol/project development, manu-
script writing/editing. VM: protocol/project development, manuscript
 5th year-resident 41 (14.9)
writing/editing. UP: protocol/project development, data analysis, manu-
 Senior 90 (32.7) script writing/editing. XM: data collection. BGT: data collection. LF: data
 Science research 29 (10.6) collection. MV: data collection. ID: data collection. MF: data collection.
Presence of Covid-19 patients, n (%) ZEK: data collection. EF: data collection. FL: data collection. CM: data
collection. TG: data collection. NS: data collection. FB: data collection.
 In the same building 253 (92)
KK: data collection. ESM: data collection. GP: protocol/project develop-
 In the same department 211 (76.7) ment; manuscript writing/editing. BP: protocol/project development; data
Sufficient protection material, n (%) 119 (43.3) management and collection; data analysis, manuscript writing/editing.
COVID-19 knowledge, n (%)
 Ability to treat COVID-19 106 (38.6) Compliancw with ethical standards 
 Updated on COVID-19 200 (72.7)
 Updated on URTI 68 (24.7) Conflict of interest  The authors declare that they have no conflict of in-
terest.
COVID-19 negative impact, n (%)
 On quality work (none to low) 109 (39.6)
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Young urologists expressed that the crisis had an impor-
tant impact on their work quality. This might be explained by Publisher’s Note Springer Nature remains neutral with regard to
the fear driven by unusual medical responsibilities far from jurisdictional claims in published maps and institutional affiliations.
surgical considerations, and far from their general medicine

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