Abstract:This study aimed to screen healthy individuals who contracted COVID‐19 for erectile dysfunction (ED) and to determine the potential risk factors that can predict ED in these individuals. One hundred and seven cases versus 90 controls agreed to participate in the study. Two structured interviews with 1 month interval were conducted. All participants were evaluated by the validated Arabic version of the international index of erectile function (IIEF‐5) and assessment of the psychological state by Hamilton depres… Show more
“…Saad et al demonstrated a significant difference in the mean IIEF-5 score between patients with COVID-19 and controls. Their multiple logistic regression model for COVID-19 ED revealed that the IIEF-5 score was an independent variable (29). Nevertheless, the results of this study found no association between IIEF-5 score and men recovering from COVID-19.…”
Background: Although the negative impact on fertility of men recovered from coronavirus disease 2019 (COVID-19) has been suggested, there is insufficient evidence, and the data are limited and contradictory.The present prospective study aimed to evaluate the sex-related hormones, semen parameters, erectile dysfunction (ED), and lower urinary tract symptoms (LUTS) in a cohort of men who recovered from COVID-19 and age-matched control men.Methods: Semen samples were collected from twenty-two men recovered from COVID-19 with a median time of 91.5 days and thirty-six control males. The semen parameters were evaluated according to the World Health Organization (WHO) laboratory manual to examine and process human semen. The blood samples were collected to assess the male hormone profile. ED and LUTS were evaluated with the International Index of Erectile Function 5 (IIEF-5) and the International Prostate Symptom Score (IPSS), respectively.
Results:The follicle-stimulating hormone (FSH) (3.819±1.515 IU/L), luteinizing hormone (LH) (4.023±1.792 IU/L), prolactin (PRL) [12.60 (10.72-15.20) ng/mL], and testosterone (T) [4.345 (3.565-5.525) ng/mL] levels were at normal range in all males enrolled in the study. Levels of semen volume (control: 2.5 mL vs. COVID-19: 1.9 mL; P<0.05) and sperm concentration (control: 59×10 6 /mL vs. COVID-19: 41.5×10 6 /mL; P<0.005) were significantly lower in males recovered from COVID-19, but still technically well within normal regardless of WHO edition. All variables were examined through logistic regression analysis, demonstrating that only sperm concentration was an independent variable associated with men recovered from COVID-19 [odds ratio (OR) =1; 95% confidence interval (CI): 0.999-1.098; P=0.016]. According to correlation analysis, there was no correlation between sperm concentration and other semen parameters and sex-related hormone profiles. Furthermore, an absence of ED and LUTS in men who recovered from COVID-19 was evidenced using the IIEF-5 and IPSS, respectively.Conclusions: Reproductive-age males recovered from COVID-19 have normal sperm concentration. Sperm concentration did not correlate with other semen parameters, sex-related hormones, IIEF-5, and IPSS. Further studies should be performed to evaluate whether the lower sperm concentration and semen
“…Saad et al demonstrated a significant difference in the mean IIEF-5 score between patients with COVID-19 and controls. Their multiple logistic regression model for COVID-19 ED revealed that the IIEF-5 score was an independent variable (29). Nevertheless, the results of this study found no association between IIEF-5 score and men recovering from COVID-19.…”
Background: Although the negative impact on fertility of men recovered from coronavirus disease 2019 (COVID-19) has been suggested, there is insufficient evidence, and the data are limited and contradictory.The present prospective study aimed to evaluate the sex-related hormones, semen parameters, erectile dysfunction (ED), and lower urinary tract symptoms (LUTS) in a cohort of men who recovered from COVID-19 and age-matched control men.Methods: Semen samples were collected from twenty-two men recovered from COVID-19 with a median time of 91.5 days and thirty-six control males. The semen parameters were evaluated according to the World Health Organization (WHO) laboratory manual to examine and process human semen. The blood samples were collected to assess the male hormone profile. ED and LUTS were evaluated with the International Index of Erectile Function 5 (IIEF-5) and the International Prostate Symptom Score (IPSS), respectively.
Results:The follicle-stimulating hormone (FSH) (3.819±1.515 IU/L), luteinizing hormone (LH) (4.023±1.792 IU/L), prolactin (PRL) [12.60 (10.72-15.20) ng/mL], and testosterone (T) [4.345 (3.565-5.525) ng/mL] levels were at normal range in all males enrolled in the study. Levels of semen volume (control: 2.5 mL vs. COVID-19: 1.9 mL; P<0.05) and sperm concentration (control: 59×10 6 /mL vs. COVID-19: 41.5×10 6 /mL; P<0.005) were significantly lower in males recovered from COVID-19, but still technically well within normal regardless of WHO edition. All variables were examined through logistic regression analysis, demonstrating that only sperm concentration was an independent variable associated with men recovered from COVID-19 [odds ratio (OR) =1; 95% confidence interval (CI): 0.999-1.098; P=0.016]. According to correlation analysis, there was no correlation between sperm concentration and other semen parameters and sex-related hormone profiles. Furthermore, an absence of ED and LUTS in men who recovered from COVID-19 was evidenced using the IIEF-5 and IPSS, respectively.Conclusions: Reproductive-age males recovered from COVID-19 have normal sperm concentration. Sperm concentration did not correlate with other semen parameters, sex-related hormones, IIEF-5, and IPSS. Further studies should be performed to evaluate whether the lower sperm concentration and semen
“…Since the beginning of the COVID-19 pandemic, there has been growing evidence of the increasing prevalence of ED in male individuals, either following the infection and/or resulting from the psychological stress associated with the pandemic 29 , 30 , 31 , 32 . Although there is increasing evidence that the pandemic has had a serious effect on sleep, little is known about how these sleep disturbances could be linked with the reported increase in the incidence of ED.…”
Introduction
: There is increasing concern about the impact of the SARS-CoV-2 pandemic on mental and physical health. Among the many possible outcomes of COVID-19, reports of sleep disturbances and erectile dysfunction are becoming prevalent worldwide.
Methods
: We sought to evaluate the recent literature on this subject to produce a narrative review of the topic by means of an extensive literature search to identify recent scientific findings on this subject.
Results
: To date, the precise mechanisms that trigger pandemic related sexual dysfunction are not completely understood, although it has been suggested that psychogenic effects play an important role, in addition to the direct effects of the disease itself on those infected. There is evidence that the stress induced by the pandemic has had a significant impact on sleep, and sleep disturbances are known to induce erectile dysfunction. Other mechanisms which trigger this phenomenon, such as hormonal changes and previous health conditions, have been suggested to be associated with SARS-CoV-2 infection, and these factors may have a potential link to sleep disturbance.
Conclusions
: The combined effect of COVID-19 and the psychogenic disorders triggered by isolation, grief, and anxiety might be associated with the increased prevalence of erectile dysfunction. This feature might be worsened by the onset of pre-existing or pandemic-induced sleep disorders. However, few studies explored this subject. Understanding this phenomenon is important for the strategic planning of treatments that could improve the quality of life of the population.
“…Other risk factors that could not be analyzed using meta-analysis are listed in Table S4. The study also found that COVID-19 was one of the risk factors for ED, and OR was higher with increasing severity of illness [ 32 , 33 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Saad et al . [ 32 ] showed that smoking, moderate COVID-19, baseline IIEF-5 scores, and severe COVID-19 in patients with COVID-19 were independent risk factors for ED. A logistic regression, adjusted for age and BMI (Sansone et al .…”
Purpose
Studies have found that erectile dysfunction (ED) may be a short-term or long-term complication in coronavirus disease 2019 (COVID-19) patients, but no relevant studies have completed a pooled analysis of this claim. The purpose of the review was to comprehensively search the relevant literature, summarize the prevalence of ED in COVID-19 patients, assess risk factors for its development, and explore the effect of the COVID-19 infection on erectile function.
Methods
Medline, Embase, and the Cochrane Library was performed from database inception until April 14, 2022. Heterogeneity was analyzed by
χ
2
tests and
I
2
was used as a quantitative test of heterogeneity. Subgroup analyses, meta-regression, and sensitivity analyses were used to analyze sources of heterogeneity.
Results
Our review included 8 studies, 4 of which functioned as a control group. There were 250,606 COVID-19 patients (mean age: 31–47.1 years, sample size: 23–246,990). The control group consisted of 10,844,200 individuals (mean age: 32.76–42.4 years, sample size 75–10,836,663). The prevalence of ED was 33% (95% CI 18–47%,
I
2
= 99.48%) in COVID-19 patients. The prevalence of ED based on the international coding of diseases (ICD-10) was 9% (95% CI 2–19%), which was significantly lower than the prevalence of ED diagnosed based on the International Index of Erectile Function (IIEF-5) (46%, 95% CI 22–71%,
I
2
= 96.72%). The pooling prevalence of ED was 50% (95% CI 34–67%,
I
2
= 81.54%) for articles published in 2021, significantly higher than that for articles published in 2022 (17%, 95% CI 7–30%,
I
2
= 99.55%). The relative risk of developing ED was 2.64 times in COVID-19 patients higher than in non-COVID-19 patients (RR: 2.64, 95% CI 1.01–6.88). The GRADE-pro score showed that the mean incidence of ED events in COVID-19 patients was 1,333/50,606 (2.6%) compared with 52,937/844,200 (0.4%) in controls; the absolute impact of COVID-19 on ED was 656/100,000 (ranging from 4/100,000 to 2352/100,000). Anxiety (OR: 1.13, 95% CI 1.03–1.26,
I
2
= 0.0%) in COVID-19 patients was a risk factor for ED.
Conclusion
COVID-19 patients have a high risk and prevalence of ED, mainly driven by anxiety. Attention should be paid to patient’s erectile functioning when treating COVID-19.
Supplementary Information
The online version contains supplementary material available at 10.1007/s40618-022-01945-w.
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