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Open Access Special Issue

COVID-19 and Erectile Dysfunction

  • Jason P. Nayar1,2,
  • Aidan J. Heslin2
  • Damien B. Beck1
  • Mark R. Wakefield2
  • Yujiang Fang1,2,*,

1Department of Microbiology, Immunology, and Pathology, Des Moines University, Des Moines, IA 50312, USA

2Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA

DOI: 10.31083/j.jomh1809190 Vol.18,Issue 9,September 2022 pp.1-4

Published: 22 September 2022

(This article belongs to the Special Issue Selected Papers in Men's Health)

*Corresponding Author(s): Yujiang Fang E-mail:


Background: The SARS-CoV-2 virus displays a strong impact on the respiratory, digestive, and reproductive systems, and has led to questions about long-term effects. Erectile dysfunction is the inability for a male to achieve or sustain an erection during sexual intercourse, and commonly develops in men due to both physiological and psychologic factors. SARS-CoV-2 can affect the vasculature that surrounds endothelial tissue and thus has raised the question of a possible relationship between SARS-CoV-2 infection and erectile dysfunction (ED). Thus far, no studies have established a relationship between COVID-19 and ED. In this review, we analyze current available data and summarize the concepts regarding the current known relationship between COVID-19 and ED. Such a study might be helpful for urologists and andrologists to manage patients with ED and a history off COVID-19 infection. Methods: A systematic review was used to analyze the relationship between COVID-19 and ED. A literature search on three databases, Google Scholar, PubMed, and ResearchGate was conducted. Search terms used were COVID-19, erectile dysfunction, and SARS-CoV-2. All available studies were analyzed up to December 2021. Results: The COVID-19 pandemic led to a significant increase in male reproductive and sexual health diagnoses, including ED, with numbers showing that COVID-19 increases the chance of developing ED nearly sixfold. Physiological issues were also found in the reproductive system of men who had contracted COVID-19. For example, endothelial progenitor cells were much lower in patients positive with COVID-19 even when compared to men with severe ED who had never contracted COVID-19. However, it is still not clear how consistent it is to find SARS-CoV-2 in the reproductive system as one study showed only two out of five testes were positive for SARS-CoV-2 in the reproductive system and another study showed that there were only 3 out of 26 cases in which the SARS-CoV-2 spike existed in the endothelia of the blood-testis barrier, seminiferous tubules, and sperm of the epididymis. Conclusions: Many correlations can be made between COVID-19 and ED. However, future testing and research must be completed to determine a causal relationship between COVID-19 and ED.


COVID-19; erectile dysfunction; SARS-CoV-2

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Jason P. Nayar,Aidan J. Heslin,Damien B. Beck,Mark R. Wakefield,Yujiang Fang. COVID-19 and Erectile Dysfunction. Journal of Men's Health. 2022. 18(9);1-4.


[1] Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, et al. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad-uate Medical Journal. 2019; 96: 753–758.

[2] Uddin M, Mustafa F, Rizvi TA, Loney T, Suwaidi HA, Al-Marzouqi AHH, et al. SARS-CoV-2/COVID-19: Viral Ge-nomics, Epidemiology, Vaccines, and Therapeutic Interventions. Viruses. 2020; 12: 526.

[3] Samudrala PK, Kumar P, Choudhary K, Thakur N, Wadekar GS, Dayaramani R, Agrawal M, Alexander A. Virology, pathogenesis, diagnosis and in-line treatment of COVID-19. European Journal of Pharmacology. 2020; 883: 173375.

[4] Al-Zaidan L, Mestiri S, Raza A, Merhi M, Inchakalody VP, Fer-nandes Q, et al. The expression of hACE2 receptor protein and its involvement in SARS-CoV-2 entry, pathogenesis, and its appli-cation as potential therapeutic target. Tumor Biology. 2021; 43: 177–196.

[5] Mihmanli I, Kantarci F. Erectile Dysfunction. Seminars in Ultra-sound, CT and MRI. 2007; 28: 274–286.

[6] Rosen RC. Psychogenic erectile dysfunction. Urologic Clinics of North America. 2001; 28: 269–278.

[7] Giuliano F, Droupy S. Dysfonction érectile. ProgrèS En Urologie. 2013; 23: 629–637.

[8] Pizzol D, Shin JI, Trott M, Ilie P-, Ippoliti S, Carrie AM, et al. So-cial environmental impact of COVID-19 and erectile dysfunction: an explorative review. Journal of Endocrinological Investigation. 2021; 45: 483–487.

[9] Bulut EC, Ertaş K, Bulut D, Koparal MY, Çetin S. The effect of COVID-19 epidemic on the sexual function of healthcare profes-sionals. Andrologia. 2021; 53: e13971.

[10] De Rose AF, Chierigo F, Ambrosini F, Mantica G, Borghesi M, Suardi N, et al. Sexuality during COVID lockdown: a cross-sectional Italian study among hospital workers and their relatives. International Journal of Impotence Research. 2021; 33: 131–136.

[11] Tanaka T, Narazaki M, Kishimoto T. IL-6 in Inflammation, Im-munity, and Disease. Cold Spring Harbor Perspectives in Biol-ogy. 2014; 6: a016295–a016295.

[12] Nazario B. Coronavirus and COVID-19: What You Should Know. 2021. Available at: (Accessed: 15 October 2021).

[13] Sivritepe R, Uçak Basat S, Baygul A, Küçük EV. The effect of interleukin-6 level at the time of hospitalisation on erectile func-tions in hospitalised patients with COVID-19. Andrologia. 2021; 54: e14285.

[14] Salama N, Blgozah S. COVID-19 and Male Sexual Functioning: a report of 3 Recovered Cases and Literature Review. Clinical Medicine Insights: Case Reports. 2021; 14: 117954762110205.

[15] Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, et al. Erectile dysfunction. Nature Reviews Disease Primers. 2016; 2: 16003.

[16] Endothelial Dysfunction. 2018. Available at:,and%20causes%20chronic%20chest%20pain (Accessed: 16 October 2021).

[17] Hew MR, Gerriets V. Prostaglandin E1. 2021. Available at: (Accessed: 10 November 2021).

[18] Nassau DE, Best JC, Kresch E, Gonzalez DC, Khodamoradi K, Ramasamy R. Impact of the SARS‐CoV‐2 virus on male repro-ductive health. BJU International. 2021; 129: 143–150.

[19] TMPRSS2 transmembrane serine protease 2 [Homo sapiens (hu-man)] - Gene - NCBI. 2021. Available at: (Accessed: 3 November 2021).

[20] Lisco G, Giagulli VA, De Pergola G, De Tullio A, Guastamac-chia E, Triggiani V. Covid-19 in Man: a very Dangerous Affair. Endocrine, Metabolic & Immune Disorders - Drug Targets. 2021; 21: 1544–1554.

[21] Duran MB, Yildirim O, Kizilkan Y, Tosun C, Cirakoglu A, Gul-tekin MH, et al. Variations in the Number of Patients Present-ing with Andrological Problems during the Coronavirus Disease 2019 Pandemic and the Possible Reasons for these Variations: a Multicenter Study. Sexual Medicine. 2021; 9: 100292.

[22] McCall B. Erectile dysfunction risk 6 times higher in men with covid. 2021. Available at: (Accessed: 27 December 2021).

[23] Kresch E, Achua J, Saltzman R, Khodamoradi K, Arora H, Ibrahim E, et al. COVID-19 Endothelial Dysfunction can Cause Erectile Dysfunction: Histopathological, Immunohistochemical, and Ultrastructural Study of the Human Penis. The World Journal of Men’s Health. 2021; 39: 466.

[24] Guo J, Sheng K, Wu S, Chen H, Xu W. An Update on the Re-lationship of SARS-CoV-2 and Male Reproduction. Frontiers in Endocrinology. 2021; 12: 788321.

[25] Ma X, Guan C, Chen R, Wang Y, Feng S, Wang R, et al. Patho-logical and molecular examinations of postmortem testis biopsies reveal SARS-CoV-2 infection in the testis and spermatogenesis damage in COVID-19 patients. Cellular & Molecular Immunol-ogy. 2021; 18: 487–489.

[26] Yao X, Luo T, Shi Y, He Z, Tang R, Zhang P, et al. A cohort au-topsy study defines COVID-19 systemic pathogenesis. Cell Re-search. 2021; 31: 836–846.

[27] Yang M, Chen S, Huang B, Zhong JM, Su H, Chen YJ, et al. Pathological Findings in the Testes of COVID-19 Patients: Clin-ical Implications. European Urology Focus. 2020; 6: 1124–1129.

[28] Blute M, Hakimian P, Kashanian J, Shteynshluyger A, Lee M, Shabsigh R. Erectile dysfunction and testosterone deficiency. Frontiers of hormone research. 2009; 37: 108–122.

[29] Mohamad N, Wong SK, Wan Hasan WN, Jolly JJ, Nur-Farhana MF, Ima-Nirwana S, et al. The relationship between circulat-ing testosterone and inflammatory cytokines in men. The Aging Male. 2019; 22: 129–140.

[30] Vaira LA, Salzano G, Deiana G, De Riu G. Anosmia and Ageusia: Common Findings in COVID-19 Patients. Laryngoscope. 2020; 130: 1787.

[31] Bertolo R, Cipriani C, Bove P. Anosmia and ageusia: a piece of the puzzle in the etiology of COVID-19-related transitory erectile dysfunction. Journal of Endocrinological Investigation. 2021; 44: 1123–1124.

[32] Bandukwala NQ. Erectile Dysfunction Psychological Causes: Stress, Depression, and More. 2021. Available at:,-What%20Is%20a&text=Vascular%20diseases%20affect%20blood%20vessels,of%20men%20who%20have%20it (Accessed: 27 December 2021).

[33] van Zyl-Smit RN, Richards G, Leone FT. Tobacco smoking and COVID-19 infection. The Lancet Respiratory Medicine. 2020; 8: 664–665.

[34] Rew KT, Heidelbaugh JJ. Erectile Dysfunction. American Family Physician. 2016; 94: 820–827.

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