“Mask up to keep it up”: preliminary evidence of the association between erectile dysfunction and covid-19

OBJECTIVES: We aimed to investigate to what extent COVID-19 affected erectile function in affected patients. METHODS: We reviewed data from the Sex@COVID online survey (performed between April 7th and May 4th, 2020 in Italy; Mollaioli et al, J Sex Med. 2021 Jan;18(1):35-49) to retrieve a sample of Italian male sexually active subjects with reported SARS-CoV-2 infection. A matching sample of COVID-19 negative sexually active male subjects was also retrieved using propensity score matching in a 3:1 ratio. The survey used different standardized psychometric tools to measure effects of lockdown and social distancing on the intrapsychic, relational, and sexual health of Italian subjects (Generalized Anxiety Dis- order scale – GAD-7, Lowe et al, Med Care 2008;46:266-274; Patient Health Questionnaire – PHQ-9, Kroenke et al, J Gen Intern Med 2001;16:606-613; Sexual Health Inventory for Men – SHIM, Rosen et al, Int J Impot Res 1999;11:319-326). RESULTS: 100 subjects were included in the analysis (25 COVID positive; 75 COVID negative). Prevalence of ED, measured with the Sexual Health Inventory for Men, was significantly higher in the COVID+ group (28% vs 9.33%; p = 0.027). Logistic regression models confirmed a significant effect of COVID-19 on the development of ED, independently of other variables affecting erectile function, such as psychological status, age and BMI [OR 5.66,95% CI: 1.50 – 24.01]. Likewise, subjects with ED were more likely to have COVID-19, once corrected for age and BMI [OR 5.27, 95% CI: 1.49 – 20.09]. CONCLUSIONS: On top of well-described pathophysiological mechanisms, the present study provides preliminary evidence in a real-life population of ED as a risk factor of developing COVID-19 and possibly occurring as a consequence of COVID-19. Universal vaccination against the COVID-19 and the personal protective equipment could possibly have the added benefit of preventing sexual dysfunctions. CONFLICTS OF INTEREST: None of the Authors report any competing interests for the present study.