番茄社区

SCOTTSDALE, Ariz. -- Having COVID-19 was tied to a somewhat increased risk of a new erectile dysfunction (ED) diagnosis, a researcher reported here.

Data from the study came from a U.S. insurance database and, after propensity matching, 230,517 men with recorded COVID-19 were identified, as were 232,645 without recorded COVID-19. After controlling for various factors, infection with SARS-CoV-2 was associated with increased risk of a new ED diagnosis (OR 1.120, 95% CI 1.004-1.248, P=0.0416), according to Kevin Chu, MD, of the University of Miami.

"The excess risk seems low. But we think that the long-term effects of COVID-19 may still be too early to know, so the risk could change as time goes on," Chu said in a presentation at the Sexual Medicine Society of North America (SMSNA) annual meeting.

But Ryan Terlecki, MD, of Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina, told 番茄社区 that he had doubts about the practical application of the findings.

"We don't know anything about a direct relationship between COVID and ED, and this study doesn't help," said Terlecki, who was not involved in the study. "This is not a look at men before and after COVID." Chu's group stated in the SMSNA abstract that men with a prior history or diagnosis of ED were excluded from the study.

T. Mike Hsieh, MD, of the University of California San Diego, told 番茄社区 that he's seen young patients who've sought treatment for ED after COVID-19 infection. He co-authored a 2021 article in stating that "COVID-19 has a uniquely harmful impact on men's health and erectile function through biological, mental health, and healthcare access mechanisms."

Hsieh, who was not involved in the current study, noted that the patients he has seen had ED symptoms that were milder than those typically seen in older men, and "Most of the guys do well with the standard treatments such as Viagra and Cialis...most will bounce back."

Chu acknowledged to 番茄社区 that "Much of how COVID effects the penis and erectile tissue remains unknown. While there has been evidence that the COVID virus may be found in penile tissue, as well as a hypothesized mechanism of endothelial dysfunction, there still remains a lot to be researched."

Chu and colleagues analyzed data from the TriNetX Research Network, a network of >42 healthcare organizations and 66 million U.S. patients, from 2009-2020. Adult men with a recorded COVID-19 infection since January 2020 were included in the study. The authors accounted for confounding variables, such as age, race, BMI, and history of comorbidities, via propensity score matching.

The men with recorded COVID-19 infection had an average age of 47.1, while 13% had diabetes mellitus, and 27% had hypertension. Men without recorded COVID-19 infection had an average age of 42.4, and 7% had diabetes, while 22% had hypertension.

Study limitations were a lack of data on the severity of ED (mild vs moderate vs complete) or the severity of COVID-19 infection.

Research into a possible COVID-ED connection is ongoing, but one found that men infected with COVID-19 were more likely to report ED (OR 5.66, 95% CI 1.50-24.01). In September, rapper Nicki Minaj tweeted that her cousin's friend in Trinidad allegedly experienced impotence after getting the COVID-19 vaccine. The tweet went viral, and both the CDC and Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, were quick to .

Another report from Italy noted that "Endothelial dysfunction, subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics all . Additionally, COVID-19 might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED."

Chu pointed out that another factor could be at play: Men with COVID-19 may see the doctor more often, which gives them more chances to mention their ED. He cited a June 2021 study reporting that "the COVID epoch has triggered a ," such as sildenafil (Viagra) and tadalafil (Cialis). That data "may go along with this alternate explanation," Chu said, adding that "What it does show is that we need to explore this topic further."

Terlecki reiterated that future research needs to examine men with documented ED before and after a [COVID] diagnosis. "It's important to recognize that we've seen many men with asymptomatic [SARS-CoV-2] infections found on routine testing for work, elective surgery, etc.," he said. "Anecdotally, I've seen a sizeable number of men without ED who had asymptomatic COVID infections based on test results done for reasons other than symptoms."

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