Erectile function three months after recovery from COVID-19

In a recently published study in Plus onethe researchers studied the manifestation of erectile dysfunction (ED) after recovery from coronavirus disease 2019 (COVID-19).

background

Persistent sexual dysfunction after COVID-19 infection, also known as sexual long COVID syndrome, is a serious problem that can affect quality of life. Research on this syndrome is still insufficient. A study showed that ED remained prevalent six to nine months after recovering from COVID-19. However, additional post-COVID-ED research is also needed to account for differences in sociocultural situations or times after recovery.

About the study

In the present study, the researchers examined erectile function and its history three months after recovery from COVID-19.

King Chulalongkorn Memorial Hospital conducted an observational cohort study of hospitalized male COVID-19 patients. The team enrolled all male patients between the ages of 18 and 70 who tested positive for COVID-19 with nasopharyngeal swab specimens and reported having engaged in sexual activity in the last two weeks between May and July 2021.

In order to stop the spread of the virus, the examination was carried out by telephone or online in patients who could not read or write. The same questionnaires were used to assess each person three months after their recovery. Age, education, body mass index (BMI), underlying medical conditions, marital status, and history of nicotine and alcohol consumption were recorded at baseline. The details of the COVID-19 vaccine and hospital treatment have been retrieved.

The International Index of Erectile Function 5 (IIEF-5) was used to assess each participant’s ability to have an erection during and three months after diagnosis of COVID-19. The Thai Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety, respectively. In addition, reports of morning penile erections in humans were compiled.

Thai IIEF-5 is a self-assessed five-item test that focuses on sexual satisfaction and erectile function in the Thai population. It is a common assessment tool used to diagnose and evaluate EDs. The stats can be broken down into five categories: severe, moderate, mild to moderate, mild, and no ED. The Thai PHQ-9 was used to assess depressive symptoms such as sad mood, loss of energy and interest, problems sleeping and eating, feelings of worthlessness, difficulty concentrating, psychomotor irregularities, and thoughts of self-harm or death. The severity of generalized anxiety disorder is measured using the GAD-7 scale. Symptoms measured included anxiety, excessive and excessive worry, difficulty falling asleep, irritability, restlessness and fear that something terrible might happen.

Results

Between May and June 2021, a total of 153 out of 654 hospitalized male COVID-19 patients reported being sexually active and eligible for research. The initial assessment included a history of COVID-19 treatment up to discharge. A second assessment, completed by 141 participants, was conducted three months after COVID-19 infection. There were no significant differences in mean age, BMI, or other variables between the first and second evaluations. Most of the study participants had educational qualifications below bachelor’s degree, were married or in a relationship and employed.

At baseline, mental health status was assessed in terms of depression and anxiety, erectile function, and self-reported normal morning erections. After examining the symptoms three months after recovering from COVID-19, the team observed notable differences in all aspects except the occurrence of anxiety and the self-reported normal morning erection. All participants whose IIEF-5 results were ED-positive underwent logistic regression at three months to identify ED-related factors.

Age and comorbidities were significant risk factors for ED and were assessed. The team found that men aged 40 and older who were suffering from major depression at the time of infection had a significant association with ED three months after COVID-19 infection. In contrast, obesity, high blood pressure, hypercholesterolemia and diabetes mellitus played an almost significant role. Because ED is a dynamic condition that changes over time, there are currently no gold standards for classifying ED related to COVID-19.

Therefore, the team divided all participants into four groups: those without ED, transient ED, persistent ED, and late-onset ED. The most typical ED was persistent ED associated with major depression during infection. After recovery, a statistically significant difference in self-reported normal morning erection was observed.

Conclusion

The study results showed that the prevalence of ED was still quite high, although it improved dramatically three months after recovering from COVID-19. In addition, male patients older than 40 years or suffering from major depressive disorder during COVID-19 were more likely to test positive for ED three months later. In the years following the end of the pandemic, physicians and patients would benefit from future studies focused on ED management, particularly for persistent ED.