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Could the coronavirus cause painful and persistent erections?

A patient diagnosed positive for the SARS-CoV-2 coronavirus recently suffered from priapism. In other words, a persistent erection. Doctors suggest a possible link with Covid-19.

A few days ago, a 62-year-old French patient visited his GP, complaining of fever, dry cough and diarrhoea. The latter, suspecting a bacterial infection, then prescribed him clarithromycin (an antibiotic). Two days later, the patient was finally hospitalized in Versailles (Yvelines) following a particularly virulent acute respiratory distress syndrome. He was therefore placed on an artificial respirator.

A persistent erection

Quick analyzes finally made it possible to make a diagnosis of Covid-19 infection. During the examinations, however, the doctors were surprised to find that this same patient was also suffering from priapism. This disorder is characterized by a painful and persistent erection (more than four hours). And this despite the absence of physical or psychological stimuli.

Normally, the corpora cavernosa of the penis fill with blood, which eventually leads to an erection. The problem is that if this erection lasts too long, in other words, if the blood is no longer evacuated afterwards, irreversible problems on the penis itself and on erectile function can then appear. C that is why it is urgent to treat the condition in time.

Aware of the problem, the doctors then compressed the patient's penis with ice packs, and sucked out the blood held inside the corpora cavernosa. They then discovered several black blood clots, which are indicative of so-called "reduced flow" (FRP) priapism.

Unlike "enlarged flow" priapism, generated by a defect in blood pressure regulation, PFR is the result of venous flow occlusion . Quickly taken care of, the patient then returned home after a few days.

Could the coronavirus cause painful and persistent erections?

A link with Covid-19?

In addition to respiratory distress, other life-threatening complications induced by the presence of the SARS CoV-2 coronavirus in the body include hyper-coagulability, which results in thromboembolic complications (formation of clots leading in particular to the risk of pulmonary embolism).

These conditions affect about a third of patients in the intensive care unit. They therefore require a specific anticoagulant strategy.

Deep vein thrombosis and pulmonary embolism are the most common forms of thrombosis, the researchers point out in the study. Ischemic stroke and acute coronary syndrome have also been reported, but less frequently. On the other hand, no penile thrombosis had yet been reported in patients with Covid-19 . So this is a first.

That's why doctors, who detail the case report in The American Journal of Emergency Medicine , evoke a possible link with the new coronavirus . Especially since patients with Covid-19 present the simultaneous presence of all the elements favoring thrombosis. Namely hyperviscosity, hypoercoagulation and endothelial dysfunction (a decrease in vessel dilation).

Nevertheless, although the arguments in favor of a causal link between Covid-19 and priapism, as well as the ischemic mechanism of priapism, are very strong in our case, further accounts of this nature would help strengthen the evidence conclude the researchers.