Thai Study Shows Erectile Dysfunction Can Affect Many Post COVID Males Even Up To Three Months After Recovery!

Long COVID Erectile Dysfunction: It seems that for Thais, sex is an important component of their life considering what the country’s night life is famous for and what social media is basically being used for in the country and the volume of pornography that is associated with Thais (just visit the porn sites and add Thai in the search functions for any category or go to sites like Only Fans) and hence it is of little wonder that of all the more concerning post COVID-19 conditions and manifestations, post-COVID erectile dysfunction issues were more relevant in the local context.


 
However, according to the Thai study team, “Numerous past studies had already validated multiple complications after COVID-19 infection, including men’s sexual health, which is caused by both physical and psychological factors. Research focusing on long-term effects among recovered patients are however still lacking.”
 
Hence the study team from Faculty of Medicine, Chulalongkorn University -Thailand, King Chulalongkorn Memorial Hospital - Thailand and the Thai Red Cross Society - Thailand decided to investigate the erectile function at three months after COVID-19 recovery along with its predicting factors.
 
The study team enrolled all COVID-19 male patients, who were hospitalized from May to July 2021, and declared to be sexually active within the previous two weeks. Demographic data, mental health status, and erectile function were collected at baseline and prospectively recollected three months after hospital discharge. To determine changes between baseline and the follow-up, a generalized linear mixed effect model (GLMM) was used. Also, logistic regression analysis was used to identify the associating factors of erectile dysfunction (ED) at three months.
 
A total of one hundred fifty-three men with COVID-19 participated.
 
Utilizing GLMM, the Long COVID Erectile Dysfunction study findings showed that ED prevalence at three months after recovery was 50.3%, which was significantly lower compared with ED prevalence at baseline (64.7%, P = 0.002).
 
Declination of prevalence of major depression and anxiety disorder was found, but only major depression reached statistical significance (major depression 13.7% vs. 1.4%, P < 0.001, anxiety disorder 5.2% vs. 2.8% P = 0.22). Logistic regression, adjusted for BMI, medical comorbidities, and self-reported normal morning erection, showed a significant association between ED at three months and age above 40 years and diagnosis of major depression with adjusted OR of 2.65, 95% CI 1.17–6.01, P = 0.02 and 8.93, 95% CI 2.28–34.9, P = 0.002, respectively.
 
The study findings showed that a high ED prevalence during the third month of recovery from COVID-19. The predicting factors of persistent ED were age over 40 years and diagnosis of major depression during acute infection.
 
The study findings were published in the peer reviewed journal: PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0276429
 
This is one of the few studies to explore the manifestation of erectile dysfunction (ED) after coronavirus disease 2019 (COVID-19) recovery.< ;br />  
Worryingly to many, persistent sexual dysfunction following COVID-19 infection, also known as sexual long COVID syndrome, is a serious issue that could impair the quality of life.
 
At present, there is not much studies on this aspect of Long COVID including the mechanism behind it and possible therapeutics.
 
A past study showed that ED remained prevalent six to nine months after COVID-19 recovery.
https://www.jsm.jsexmed.org/article/S1743-6095(21)00656-1/fulltext
 
It was noted however, additional post-COVID-ED research is also required to address variations in sociocultural situations or post-recovery times.
 
The study team conducted an observational cohort study of hospitalized male COVID-19 patients.
 
The researchers enrolled all male patients between 18 and 70 years who tested positive for COVID-19 with nasopharyngeal swab specimens and who reported having engaged in sexual activity in the previous two weeks between May and July 2021.
 
In order to stop the spread of the virus, the examination was done over the phone or online with patients who could not read or write. The same questionnaires were used to appraise each individual three months after their recovery. Age, education, body mass index (BMI), underlying diseases, marital status, and history of nicotine and alcohol usage were recorded at baseline. The COVID-19 vaccine and hospitalization treatment details were retrieved.
 
The IIEF-5 or International Index of Erectile Function 5 was utilized to evaluate each participant's erectile function during and three months after being diagnosed with COVID-19. The Thai Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety, respectively. Additionally, reports of penile morning erections from people were compiled.
 
The Thai version of the IIEF-5 is a self-rated test with five questions focusing on sexual intercourse satisfaction and erectile function in the Thai population. It is a common evaluation tool for diagnosing and evaluating EDs. Its scores could be divided into five categories: severe, moderate, mild to moderate, mild, and no ED.
 
Furthermore, the Thai PHQ-9 was used to assess depressive symptoms such as sad mood, loss of energy and interest, problems sleeping and eating, feelings of worthlessness, difficulty focusing, psychomotor irregularities, and thoughts of self-harm or death.
 
Also, the severity of generalized anxiety disorder is measured using the GAD-7 scale. The measured symptoms included anxiety, unrestrained and excessive worrying, difficulty falling asleep, irritability, restlessness, and fear that something terrible might occur.
 
A total of 153 of 654 hospitalized male COVID-19 patients between May and June 2021, reported being sexually active and qualified for the research.
 
For the study, the initial assessment included the collection of the history of COVID-19 treatment up until discharge. A second evaluation fully completed by 141 participants was obtained three months following the COVID-19 infection.
 
It was noted that between the first and second evaluations, there were no appreciable differences in mean age, BMI, or other variables. Most study participants had education levels below a bachelor's degree, were married or in relationships, and were employed. At baseline, mental health status concerning depression and anxiety, erectile function, and self-reported normal morning erection was assessed.
 
Interestingly, after examination of symptoms three months after COVID-19 recovery, the study team observed remarkable differences in all aspects except the incidence of anxiety and self-reported normal morning erection.
 
All study participants whose IIEF-5 findings were ED-positive underwent a logistic regression to identify ED-related factors at three months. Age and comorbidities were significant ED risk factors and were assessed.
 
The study team noted that males aged 40 years and older and having major depression at the time of infection had a significant association with ED after three months after COVID-19 infection.
 
However, on the other hand, being overweight and suffering from hypertension, hypercholesterolemia, and diabetes mellitus were almost significant.
 
As ED is a dynamic disorder that changes over time, there are currently no gold standards for classifying ED associated with COVID-19.
 
The study team hence divided all study participants into four groups: those with no ED, transient ED, persistent ED, and later onset ED. The most typical ED was persistent ED, which was associated with severe depression during infection. Following recovery, a statistically considerable difference was observed in self-reported normal morning erection.
 
Importantly, the study findings revealed that the prevalence of ED was still quite high even though it dramatically improved three months after COVID-19 recovery.
 
Furthermore, it was found that male patients older than 40 or experiencing major depressive disorder during COVID-19 were more likely to test positive for ED three months later.
 
The study team noted that in the years following the end of the pandemic, doctors and patients would benefit from future studies concentrating on ED management, particularly in persistent ED.
 
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