The Change of Erectile Function Post Recovery from COVID-19 Infection

Introduction: We assess the correlation between COVID-19 infection and erection and evaluate the effect of aging and comorbidities on the male sexuality of patients with COVID-19 infection. Methods: 100 patients were enrolled and diagnosed with COVID-19 based on reverse transcription-polymerase chain reaction tests of oropharyngeal and nasopharyngeal swabs according to the WHO guidelines. The International Index of Erectile Function (IIEF-5) questionnaire was used to evaluate sexual function. Results: Patients were divided into two groups: the first group of 42 patients <50 years of age with a mean age (+/- SD) of 35.83 +/- 7.8 and the second group of 58 patients >= 50 years of age with a mean age of 58.64 +/- 7.7. The mean (+/- SD) IIEF in the first group pre-COVID-19 infection was 14.2 +/- 2.37 while post-COVID-19 was 8.7 +/- 2.77, 11.3 +/- 2.9, 12.1 +/- 3.02 at 1, 3, 6 months, respectively (p < 0.001), while in the second group, the mean (+/- SD) IIEF pre-COVID-19 infection was 10.04 +/- 4.62 while post-COVID was 5.0 +/- 2.1, 6.56 +/- 2.6, 8.18 +/- 2.04 at 1, 3, 6 months, respectively (p < 0.001). On multivariate analysis, old patients infected with COVID-19 and associated with comorbidities such as diabetes mellitus (OR = 8.53, CI = 0.00-2.01), hypertension (OR = 3.908, CI = 0.000-3.07), ischemic heart disease (OR = 2.863, CI = 0.000-2.68), and liver disease (OR = 0.670, CI = 0.000-1.670) were significantly correlated to erectile dysfunction (p < 0.001). Conclusion: COVID-19 significantly affects erection mostly in older patients with comorbidities, leading to subsequent use of oral and intracavernosal injection therapy for erectile dysfunction.