key: cord-1043848-ibapexn1
authors: Sansone, Andrea; Jannini, Emmanuele A.
title: COVID-19 and Erectile Dysfunction: Endothelial Dysfunction and Beyond
date: 2021-06-07
journal: World J Mens Health
DOI: 10.5534/wjmh.210081
sha: 08abf3c8e9a71077d2d5fa263f3f42e307e3bc92
doc_id: 1043848
cord_uid: ibapexn1

nan

reproductive health. As sexual activity has been demonstrated to act as a coping mechanism during lockdown [2] , we believe that taking care of sexual health to preserve psychological health should be considered as a first-line treatment for COVID-19 long haulers. Several factors can possibly contribute to the onset of ED, or to the progression from subclinical to overt forms, in COVID-19 patients: on top of the endothelial dysfunction, subclinical hypogonadism, impaired pulmonary hemodynamics, and severe psychological burden can potentially affect erectile response [3] . The association of COVID-19 and sexual dysfunction has also been proven in our pilot study among Italian subjects [4] , surprisingly not mentioned by Dr. Kresch and coworkers, showing an almost six-fold higher risk of having ED among COVID-19 subjects, once corrected for confounding factors, including age, body mass index (BMI), and psychological status (odds ratio [OR], 5.66; 95% confidence interval [CI], 1.50-24.01).

As more severe cardiovascular events can be predicted by the onset of ED [5] , we believe that highlighting the potential role of ED as a "canary in the coal mine" would be relevant not only to sexual medicine experts, but also to the scientific community and to the general www.wjmh.org population as well. Indeed, the association between ED and COVID-19 is bidirectional, with a more than fivefold risk of contracting COVID-19 among subjects with impaired erectile function (OR, 5.27; 95% CI, 1.49-20.09), owing to the shared risk factors for both conditions such as increasing age and BMI [4] .

COVID-19 endothelial dysfunction can cause erectile dysfunction: histopathological, immunohistochemical

Benefits of sexual activity on psychological, relational, and sexual health during the COVID-19 breakout

Addressing male sexual and reproductive health in the wake of COVID-19 outbreak

Mask up to keep it up": preliminary evidence of the association between erectile dysfunction and COVID-19

The 2018 revision to the process of care model for management of erectile dysfunction

Emmanuele A. Jannini was partially supported by PRIN grant #2017S9KTNE_002.

The authors have nothing to disclose.