COVID-19 and Erectile Dysfunction
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
*Corresponding Author(s): Yujiang Fang E-mail: email@example.com
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
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.
 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.
 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.
 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.
 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.
 Mihmanli I, Kantarci F. Erectile Dysfunction. Seminars in Ultra-sound, CT and MRI. 2007; 28: 274–286.
 Rosen RC. Psychogenic erectile dysfunction. Urologic Clinics of North America. 2001; 28: 269–278.
 Giuliano F, Droupy S. Dysfonction érectile. ProgrèS En Urologie. 2013; 23: 629–637.
 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.
 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.
 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.
 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.
 Nazario B. Coronavirus and COVID-19: What You Should Know. 2021. Available at: https://www.webmd.com/lung/coronavirus (Accessed: 15 October 2021).
 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.
 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.
 Yafi FA, Jenkins L, Albersen M, Corona G, Isidori AM, Goldfarb S, et al. Erectile dysfunction. Nature Reviews Disease Primers. 2016; 2: 16003.
 Endothelial Dysfunction. 2018. Available at: https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/endothelial-dysfunction.html#:~:text=Endothelial%20dysfunction%20is%20a%20type,and%20causes%20chronic%20chest%20pain (Accessed: 16 October 2021).
 Hew MR, Gerriets V. Prostaglandin E1. 2021. Available at: https://www.ncbi.nlm.nih.gov/books/NBK546629/ (Accessed: 10 November 2021).
 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.
 TMPRSS2 transmembrane serine protease 2 [Homo sapiens (hu-man)] - Gene - NCBI. 2021. Available at: https://www.ncbi.nlm.nih.gov/gene/7113 (Accessed: 3 November 2021).
 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.
 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.
 McCall B. Erectile dysfunction risk 6 times higher in men with covid. 2021. Available at: https://www.webmd.com/lung/news/20210407/erectile-dysfunction-risk-6-times-higher-in-men-with-covid (Accessed: 27 December 2021).
 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.
 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.
 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.
 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.
 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.
 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.
 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.
 Vaira LA, Salzano G, Deiana G, De Riu G. Anosmia and Ageusia: Common Findings in COVID-19 Patients. Laryngoscope. 2020; 130: 1787.
 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.
 Bandukwala NQ. Erectile Dysfunction Psychological Causes: Stress, Depression, and More. 2021. Available at: https://www.webmd.com/erectile-dysfunction/guide/ed-psychological-causes#:~:text=In%20this%20Article,-What%20Is%20a&text=Vascular%20diseases%20affect%20blood%20vessels,of%20men%20who%20have%20it (Accessed: 27 December 2021).
 van Zyl-Smit RN, Richards G, Leone FT. Tobacco smoking and COVID-19 infection. The Lancet Respiratory Medicine. 2020; 8: 664–665.
 Rew KT, Heidelbaugh JJ. Erectile Dysfunction. American Family Physician. 2016; 94: 820–827.
Vol., Issue , Invalid dateTable of contents
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.
SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)
Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.
Scopus CiteScore 0.7 (2021) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (https://kanalregister.hkdir.no/publiseringskanaler/Forside).