Endocrinology and Medical Sexology (ENDOSEX, Department of Systems Medicine, University of Rome Tor Vergata, Roma, Italy.
Department of Dynamic and Clinical Psychology, Health Studies "Sapienza" University of Rome, Rome, Italy.
Andrology. 2021 Jul;9(4):1053-1059. doi: 10.1111/andr.13003. Epub 2021 Mar 30.
Erectile dysfunction (ED), as the hallmark of endothelial dysfunction, could be a short- or long-term complication of COVID-19. Additionally, being ED a clinical marker and predictor of non-communicable chronic diseases, particularly cardiovascular, subjects with ED could potentially have a higher risk of contracting COVID-19.
To investigate the prevalence of ED among subjects with a reported diagnosis of COVID-19 and to measure the association of COVID-19 and ED.
We reviewed data from the Sex@COVID online survey (performed between April 7 and May 4, 2020, in Italy) to retrieve a sample of Italian male sexually active subjects with reported SARS-CoV-2 infection. A matching sample of COVID-19-negative male sexually active 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.
One hundred subjects were included in the analysis (25 COVID-positive; 75 COVID-negative). The 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].
On top of well-described pathophysiological mechanisms, there is 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.
勃起功能障碍（ED）是内皮功能障碍的标志，可能是 COVID-19 的短期或长期并发症。此外，ED 是一种临床标志物和预测非传染性慢性疾病的指标，尤其是心血管疾病，ED 患者可能有更高的 COVID-19 感染风险。
调查报告 COVID-19 诊断的患者中 ED 的患病率，并测量 COVID-19 和 ED 之间的关联。
我们回顾了 Sex@COVID 在线调查（2020 年 4 月 7 日至 5 月 4 日在意大利进行）的数据，以检索报告 SARS-CoV-2 感染的意大利男性活跃性受试者的样本。还使用倾向评分匹配以 3:1 的比例检索了 COVID-19 阴性男性活跃性受试者的匹配样本。该调查使用不同的标准化心理计量工具来测量封锁和社会隔离对意大利受试者的内在心理、关系和性健康的影响。
100 名受试者纳入分析（25 名 COVID 阳性；75 名 COVID 阴性）。使用男性性健康问卷测量的 ED 患病率在 COVID+组中显著更高（28% vs. 9.33%；p=0.027）。逻辑回归模型证实 COVID-19 对 ED 的发展有显著影响，独立于影响勃起功能的其他变量，如心理状态、年龄和 BMI[比值比 5.66，95%置信区间：1.50-24.01]。同样，校正年龄和 BMI 后，ED 患者更有可能感染 COVID-19[比值比 5.27，95%置信区间：1.49-20.09]。
除了已描述的病理生理机制外，在真实人群中，ED 作为 COVID-19 的发病风险因素的初步证据，以及可能作为 COVID-19 的后果出现，这是初步证据。针对 COVID-19 的普遍疫苗接种和个人防护设备可能具有预防性功能障碍的额外益处。
