COVID-19 and sexual dysfunction in men: SARS-CoV-2 in the testes

OBJECTIVES: Mortal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been known to cause many signs/symptoms reported by authors from Wuhan (China), but none of these early reports and papers has specifically included male sexual dysfunction as one of these major symptoms until mid-2020. The primary aim of this interesting research study is to examine and investigate the possible relationship between the coronavirus disease 2019 (COVID-19) and the sudden temporary sexual dysfunction in adult males during the pandemic. Some other secondary hypotheses will be also investigated. MATERIAL AND METHODS: With the onset of COVID-19 pandemic, we have noticed an intense increase in the number of male patients who have presented to andrologists with new sudden onset of various moderate to severe sexual dysfunction problems (e.g., erectile dysfunction/impotence, infertility, and hypogonadism) in Egypt and USA hospitals and clinics along with telemedicine consultations. The high frequency with which patients present with these sexual problems was extremely unusual. Herein, we described patients who have presented with unexpected moderate to complete loss of their sexual abilities (which did not happen before in that unreasonable way) with the presence of normal and intact sexual desire during a five-week period of the COVID-19 pandemic. RESULTS: Most of these male patients had either no COVID-19 symptoms or very mild-to-moderate respiratory symptoms known in COVID-19 patients. Although most of patients had normal otolaryngologic exam results, but, surprisingly, almost all tested positive for COVID-19. A strong relationship between COVID-19 and sudden sexual dysfunction in men should certainly be considered and investigated during the pandemic. CONCLUSION: We mainly deduced, for the first time, that SARS-CoV-2 invasion of the male's reproductive system may directly cause sudden temporary sexual dysfunction problems ranged from unobserved moderate to irritatingly severe and complete in their pathologic outcomes, hence sex should be avoided during the pandemic peaks.