Profilaktik tibbiyot va salomatlik
–
Профилактическая
медицина
и
здоровье
–
Preventive Medicine
and Health
Journal home page:
https://inscience.uz/index.php/preventive-medicine
Changes in the sexual activity of men with COVID-19
Rustambek BOBOEV
Andijan State Medical Institute
ARTICLE INFO
ABSTRACT
Article history:
Received August 2023
Received in revised form
10 September 2023
Accepted 25 September 2023
Available online
15 October 2023
Erectile dysfunction (ED) is a common form of sexual
dysfunction that significantly impacts both the physical and
mental well-being of the affected man and his partner. This, in
turn, can lead to social maladjustment. The pathogenesis of
erectile dysfunction is multifactorial, encompassing arterial,
neurogenic, hormonal, cavernous, iatrogenic, and psychogenic
causes.
In light of the coronavirus pandemic, complications related
to COVID-19 are being increasingly observed. These
complications not only involve the respiratory system but also
include urogenital manifestations and issues, particularly the
potential impact of coronavirus infection on male fertility.
2181-3663
/©
2023 in Science LLC.
https://doi.org/10.47689/2181-3663-vol2-iss5-pp1-6
This is an open-access article under the Attribution 4.0 International
(CC BY 4.0) license (
https://creativecommons.org/licenses/by/4.0/deed.ru
Keywords:
COVID-19,
coronavirus infection,
erectile dysfunction,
male fertility,
pandemic,
testosterone.
COVID-19 bilan kasallangan erkaklar jinsiy faoliyatidagi
o‘zgarishlar
ANNOTATSIYA
Kalit so‘zlar
:
COVID-19,
koronavirus infeksiyasi,
erektil disfunksiya,
erkaklarning fertilligi,
pandemiya,
testosteron.
Erektil disfunksiya
–
jinsiy zaiflikning keng tarqalgan turi
bo‘lib, u erkak va uning ayoli hayotining jismoniy va ruhiy
tomonlariga ta’sir qiladi, bu esa o‘z navbatida shaxsning
ijtimoiy moslasha olmasligiga olib kelishi mumkin. Erektil
disfunksiyaning patogenezi ko‘p omillarga bog‘liq bo‘lib,
arterial, neyrogen, gormonal, kavernoz, yatrogen va psixogen
sabablarni o‘z ichiga oladi. Koronavirus pandemiyasi bilan
bog‘liq holda, COVID
-19 asoratlari nafaqat nafas olish tizimidagi
shikastlanish belgilari, balk
i urogenital ko‘rinishlar va asoratlar,
xususan, korona virus infeksiyasining erkaklar fertilligiga ta’siri
bilan ham tez-
tez paydo bo‘lmoqda.
1
Senior lecturer, Department of Urology, Faculty of Medicine, Andijan State Medical Institute.
E-mail: boboev.rustambek1983@mail.ru
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Изменения в сексуальной активности мужчин с COVID
-19
АННОТАЦИЯ
Ключевые слова:
COVID-19,
коронавирусная
инфекция,
эректильная дисфункция,
мужская фертильность,
пандемия,
тестостерон.
Эректильная дисфункция является распространенным
типом
сексуальной
дисфункции,
затрагивающим
физические и психические аспекты жизни как самого
мужчины, так и его партнерши. Это, в свою очередь, может
привести к социальной дезадаптации личности. Патогенез
эректильной дисфункции носит многофакторный характер
и включает артериальные, нейрогенные, гормональные,
кавернозные, ятрогенные и психогенные причины.
В условиях пандемии коронавируса всё чаще
выявляются осложнения COVID
-
19, которые проявляются
не только поражением дыхательной системы, но и
урогенитальными нарушениями. В частности, фиксируется
влияние
коронавирусной
инфекции
на
мужскую
фертильность.
Erectile dysfunction is a widespread type of sexual dysfunction that affects the
physical and mental aspects of the life of both the man himself and his partner, which, in
turn, can lead to social maladaptation of the individual [1, 3, 4].
Enough data indicates that erectile dysfunction (ED) is a polyetiological condition.
Three main key factors can contribute to the development of ED to a large extent:
systemic diseases, medication, and unfavorable lifestyle factors (diet, smoking, physical
inactivity). It should be noted that age will not act as a determining factor in the
development of ED. According to the results of epidemiological studies, with age in men,
an increase in the frequency of somatic burdens is recorded, including arterial
hypertension (AH), coronary heart disease (CHD), diabetes mellitus (DM), overweight,
and other metabolic factors that hurt erectile function. [2, 5, 6].
Scientists at the University of Miami have revealed the impact of COVID-19 on
potency [7, 8, 9, 10, 12]. The results of the study showed that the coronavirus persists in
the tissues of the penis for a long time after recovery, which can lead to erectile
dysfunction [3, 7, 8, 9, 11]. All this determines the relevance of an integrated approach to
the diagnosis of erectile dysfunction to verify the true cause.
The purpose of the study
is to establish post-covid changes in erectile
dysfunction in men.
MATERIAL AND RESEARCH METHODS
From 2021 to 2022, 46 men who had COVID-19 pneumonia were consulted in the
urology department of the clinic of the Andijan State Medical Institute. The duration of
the disease ranged from 3 to 6 months. For comparison, a control group of 12 men who
did not have COVID-19 pneumonia was taken. The age of the patients ranged from 38 to
57 years. All of them had at least one PCR-positive respiratory swab for COVID-19.
Anamnestic ally, all patients, based on computed tomography (CT) of the chest, were
diagnosed with pneumonia of varying severity.
The diagnostic complex included a physical examination, general blood and urine
tests, a biochemical blood test, an ultrasound examination of the prostate gland and
scrotum organs, a study of the level of a common prostate-specific antigen, an analysis of
hormonal status
–
total level of testosterone (T), luteinizing hormone (LH) was
determined, prolactin (P), ejaculate (sperm) smear examination.
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Patients were surveyed using the following questionnaires: IIEF (The international
index of erectile function, International Index of Erectile Function, IIEF-5); IPSS
(International Prostate Symptom Score, International Prostate Symptom Index, a scale
for the overall assessment of prostate diseases); AMS (Aging Males Symptoms, Male
Aging Symptoms Questionnaire).
The results of the study
showed that 46 patients who recovered from COVID-19
pneumonia complained of a pronounced decrease in libido, erectile function and the
quality of sexual intercourse after the illness. The consequences of COVID-19 in
8 patients were expressed in the absence of morning erection, complete dissatisfaction
from sexual intercourse, and the absence of libido.
The laboratory level of testosterone in men of the control group was
12.0-14.0 nmol/l, which is the norm according to the recommendations of ISSAM
(International Society for the Study of Aging and Men's Health).
The laboratory level of testosterone in the men of the examined group was
different depending on the severity of the course of the COVID -19 disease in the
anamnesis: for example, in 8 patients who were treated in COVID intensive care using
non-invasive mechanical ventilation in the CPAP mode (constant positive airway
pressure mode
–
Continuous Positive airway Pressure ), was lower
–
from 4 to 6 nmol/l;
in 6 patients who were on support with moistened O
2
in history, testosterone was 8 nmol
/l; in 32 patients who underwent a mild course of COVID -19, testosterone levels ranged
from 8.67 to 10 nmol / l. Based on these data, it can be assumed that COVID infection has
a negative impact on erectile function, reducing testosterone levels.
Table 1.
Diagnostic criteria by groups
Study
Control group
Patients who have undergone COVID -19
In mild degree
Moderately
To a severe
degree
number of subjects
(men)
12
32
6
8
testosterone
(nmol /l)
12-14
8.48-10.0
7.11-8.37
8.67-10.0
prostate secret
leukocytes
4-6
5-8
10-12
in great numbers
prostate secret
bacteria
-
+
+
++
test for IIEF-5
(In points)
19-23
16-18
12-14
5-7
IPSS questionnaire
6
9
12
14
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Pic. 1. Diagnostic criteria by groups
SARS-CoV-2 is a new B-coronavirus that is believed to have originated in bats, but
the intermediate between them and humans has not yet been identified. It is highly
contagious, and the main routes of transmission are contact and airborne. The incubation
period for SARS-CoV-2 ranges from 2 to 14 days.
The SARS-CoV-2 virus has been detected in the ejaculate of COVID-19 patients,
both convalescent and acutely ill.
Pic. 2. Detection of SARS-CoV-2 in semen.
0
5
10
15
20
25
Control
group
in mild
degree
moderately
to a severe
degree
testosterone
Leukocytes in semen
Test for IIEF-5
Recovered
Patients (70%)
Patients in
recovery (30%)
4 (+) ejaculate test
2(+) ejaculate test
Study Patients
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As can be seen from the diagram, out of 46 patients, 32 (70%) patients considered
themselves to be quite healthy, and 14 (30%) were in the recovery stage. As a result,
6 (42.8 %) patients tested positive for SARS-CoV-2 in semen, including 4 (28.5%) of
14 patients in the acute period and 2 (6.25 %) of 32 recovered patients.
Based on the above, it can be concluded that the coronavirus persists in the tissues
of the penis for a long time after recovery, which can lead to erectile dysfunction.
We believe that this occurs as a result of a violation of the blood supply to the mucous
membrane of small blood vessels, the tissues fed by them cease to be normally supplied
with blood and lose their functions. This dysfunction of the blood vessels can lead to the
development of impotence in men who have recovered from COVID-19.
FINDINGS:
1.
Coronavirus SARS-CoV-2 can seed the male reproductive tract and persist in it
for a certain time.
2.
The degree of damage to the reproductive tract by coronavirus depends on the
severity of the course of the transferred COVID-19 infection.
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