It can be safely said that COVID-19 has extracted a massive toll on the physical, emotional, and psychological health of its survivors. Now, it seems like it can mar one's sexual health as well. According to a new study, men who have had the SARS-CoV-2 coronavirus infection may face erectile dysfunction.

The research by scientists from the University of Miami Miller School of Medicine stated that the virus can remain in the penile tissue long after the male survivors make a recovery. Extensive endothelial dysfunction (blood vessel impairment)—a result of the viral infection—could eventually give rise to erectile dysfunction (ED) in men who had no prior history of the condition, the study asserted.

"In our pilot study, we found that men who previously did not complain of erectile dysfunction developed pretty severe erectile dysfunction after the onset of COVID-19 infection," said Dr. Ranjith Ramasamy, author of the study, in a statement. The paper is the first to demonstrate the presence of COVID-19 in penile tissue.

Dysfunctions and Damages

Blood Vessel
A blood vessel (Representational Picture)Youtube Screengrab/ Renew ECP Therapy

Endothelial dysfunction is a condition where the endothelial layer or endothelium (the inner lining) of arteries do not perform their functions sufficiently. Here, the arteries fail to dilate completely in response to the stimulus they receive. The dilatory function decides on a second-to-second basis the amount of blood that various tissues in the body receive.

Therefore, tissues and the organs supplied by dysfunctioning vessels can undergo severe damage. This can result in complications such as strokes, heart attacks, and organ failure. Endothelial dysfunction triggered by COVID-19 has also been found to worsen the infection's pathogenesis. 

Also known as impotence, ED is a condition where men face chronic difficulty in achieving and maintaining an erection that is adequate to engage in sexual activity. While it is a condition that is commonly reported in middle-aged and older men, it is not uncommon across other age groups.

ED develops due to ailments such as diabetes, cardiovascular disease (CVD), and neurological conditions. It can also arise due to psychological conditions and as a side effect of prescription medications. Habits such as smoking and drug abuse have also been attributed to the onset of ED.  Importantly, studies have linked endothelial dysfunction with ED. Around 320 million men across the world could suffer from ED by 2025

Looking for the Virus

SARS-CoV-2 Coronavirus
SARS-CoV-2 Coronavirus (Representational Picture)Pixabay

For the study, the researchers obtained penile tissue samples from patients with severe ED who were undergoing penile prosthesis surgery due to the condition. Two of these recruited patients had a history of COVID-19. They had contracted the infection six and eight months prior.

While one had experienced mild symptoms of the disease, the other had been hospitalized. Most importantly, both the men had 'normal erectile function' without the assistance of medication before their COVID-19 infections

Samples from two surgery patients, who had not been infected with COVID-19 were also collected. All the procured tissue samples were investigated for the presence of the SARS-CoV-2 virus as well as endothelial dysfunction.

COVID-19 in Penile Tissue

The authors found the presence of the virus in the samples obtained from the two patients who had been infected with COVID-19 less than a year before the surgery. Naturally, in the samples of the two patients who had not contracted the infection, there was no presence of the pathogen. 

Penile Tissue COVID-19
Ultrastructure features of penile tissue from live seroconverted COVID-19 patients. (A) Coronavirus-like spiked viral particles (arrows) visualized via TEM in the peri-vascular erectile tissue of a live patient who had previously contracted the COVID-19 virus and subsequently seroconverted. Particle diameter measurement indicated on image. (B) Coronavirus-like spiked viral particles (arrows) visualized via TEM in the peri-vascular erectile tissue of a live patient who had previously contracted the Covid-19 virus and subsequently seroconverted. Particle diameter measurement indicated on imageDr. Ranjith Ramasamy/University of Miami Health System

Evidence of endothelial dysfunction in the tissues of the patients with COVID-19 (in the past) was also discovered. However, it was not detected in samples of the patients who had not been afflicted with the disease.

"This suggests that men who develop COVID-19 infection should be aware that erectile dysfunction could be an adverse effect of the virus, and they should go to a physician if they develop ED symptoms," emphasized Dr. Ramasamy.  

Potential Impact on Male Fertility

Based on their findings, the authors theorize that much like the other complications set off by COVID-19, ED could be a consequence of extensive infection and the resulting endothelial dysfunction. They also added that the presence of the virus in the penile tissue may contribute to the aggravation of ED.

Man depressed (Representational Picture)Flickr/Mic445

The latest findings are along the same lines as those noted by Dr. Ramasamy and his colleagues in an older research. Through the study, the scientists learnt that COVID-19 can attack the testis tissue in men infected by the coronavirus. This, according to the authors, may serve as the stepping stone in the comprehension of the potential role of SARS-CoV-2 in male fertility, especially the possibility of its sexual transmission.

Highlighting the importance of protecting one's self from the infection in order to avoid complications, Eliyahu Kresch, first of the study, stressed, "These latest findings are yet another reason that we should all do our best to avoid COVID-19. We recommend vaccination and to try to stay safe in general."