More than a year after COVID-19 was described, this disease, caused by the SARS-CoV-2 coronavirus, has generated hundreds of thousands of published studies on its symptoms, complications and side effects. Today we know that COVID-19 is much more than a respiratory disease: it is rather a multisystemic disease, which can affect several organs in addition to the lungs (brain, liver, kidneys, intestines, heart and blood vessels … ).
Once the context is located, we can prepare ourselves to better understand a ‘news’ that circulates in the last hours in some digital media: “The permanent erection, ‘new’ side effect of COVID-19” . What is true in this headline? Can COVID-19 cause this very specific symptom and, apparently, so little related to the disease? Is this striking ‘side effect’ new? Next, we will analyze what is behind this news already deny all the false information that has been disseminated in this regard (we imagine, due to the morbidity of the organ in question).
It all stems from a study published by The American Journal of Emergency Medicine that describes the case of a 69-year-old man from Ohio who was hospitalized for COVID-19, and who developed a prolonged erection during his admission. However, this study is not new, but was published in June 2020 (for some reason, the case has been rescued and released by the press in recent hours).
As detailed in the study, the man was admitted to the emergency room after a week of coughing, congestion, dyspnea, anorexia and generalized weakness, later showing signs of bilateral pneumonia in his lungs. Once there, he tested positive for SARS-CoV-2. It was after several hours of being hospitalized that the erection occurred , but this was not the reason that led him to be admitted: “In the supination of the following afternoon, the nursing staff noticed an erection. Ice packs were placed, but the erection persisted for the next 3 hours with rigidity of the corpora cavernosa and a flaccid glans, ”the document describes.
What we commonly know as ‘prolonged erection’ is referred to in medical terms as priapism (from the Greek deity Priapus, a lesser god of fertility). This pathology consists of an erection that is not related to sexual stimulation and that, in general, only involves the corpora cavernosa. According to Manuel Carbonero, associate chief urologist in the Urology department of the Valdemoro Hospital in Madrid, priapism responds to a veno-occlusive mechanism that is altered. “During erection, the erotic stimulus causes the endothelium, the inner layer of blood vessels in the penis, to allow blood to enter and a kind of ‘swamp’ forms, a flood, which causes an erection.” In the case of an erection that does not disappear, where sexuality is not involved, there is an alteration in this normal mechanism of the body, which can be produced by various causes (a spinal cord injury, for example, but also by effect substances such as medications and other drugs).
“It could be that COVID-19, which is a multisystemic disease, can cause the alteration of the erection mechanism, just as it has produced cerebral or pulmonary embolisms , altering the mechanism of inflammation of the vessels, that is, causing inflammation in endothelial cells ”, Carbonero ventures.
Therefore, do we already affirm that COVID-19 caused this individual to have a prolonged erection? If we continue reading the report on the patient’s progress, we can only conclude that it is not clear. The reason? A drug called propofol and with which this person was intervened in order to treat COVID-19.
There are two types of priapism or prolonged erection: low-flow or ischemic, or high-flow or venous. “Ischemic priapism, in the long run, produces an alteration of the veno-occlusive mechanism and the tissues of the penis, which can lead to tissue destruction”, as Dr. Carbonero clarifies. In fact, the study details how the patient was diagnosed with such a condition: “Due to continuous suspicion, a cavernous blood gas was obtained that revealed a pH compatible with ischemic priapism .”
And here’s what’s cool : The same study details how case reports suggest that propofol can cause ischemic priapism. Resuted matter, right?
Well no: in the case that concerns us here, the patient received propofol for more than 12 hours before with no observable problems, which leads us to believe that propofol was not the direct trigger. The researchers conclude: “The prevalence of coagulopathy in COVID-19 and the associated risk of mortality requires greater attention to its probability as a precipitating factor.” That is, the prolonged erection could have occurred as a consequence caused by several factors at the same time, among which both COVID-19 and propofol could play a fundamental role.
This means that they have neither discovered that prolonged erection is ‘a new side effect’ of COVID-19 nor that this possible effect is common in men infected with the coronavirus. Rather, it seems an isolated event (and it seems that, for now, the only one reported) of a case of ischemic priapism aggravated or complicated by COVID-19.
To dig deeper into the matter, the scientists participating in the study say that more research will be needed when it comes to hypercoagulation in COVID-19 patients.
Understanding, then, this striking news, we can conclude that we do not know if the prolonged erection was caused by the medication administered, COVID-19, perhaps the general health of the patient (who had a history of obesity), or a combination of all these factors. In any case, it does not seem that the two circumstances are easily related, and this should not be the result of major concerns for COVID-19 positive men.
