IMR Press / JOMH / Volume 18 / Issue 9 / DOI: 10.31083/j.jomh1809190
Open Access Review
COVID-19 and Erectile Dysfunction
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1 Department of Microbiology, Immunology, and Pathology, Des Moines University, Des Moines, IA 50312, USA
2 Department of Surgery, University of Missouri School of Medicine, Columbia, MO 65212, USA
*Correspondence: (Yujiang Fang)
J. Mens. Health 2022, 18(9), 190;
Submitted: 17 March 2022 | Revised: 7 April 2022 | Accepted: 8 April 2022 | Published: 9 September 2022
(This article belongs to the Special Issue Selected Papers in Men's Health)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

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.

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