Some Covid-19 patients may present with respiratory problems, fatigue, headaches, loss of taste or smell… and even speech disorders. erection according to a small study recently published. These would be inherent in vascular disturbances. However, these conclusions should be qualified.
We know from previous work that the ability of Covid-19 to enter cells is highly dependent on the presence of angiotensin-2 converting enzyme (ACE). -2). We also know that before binding to ACE-2 receptors, viral spike proteins must be primed by cellular proteases, specifically transmembrane protease serine 2 (TMPRSS-2).
This is why Covid-19 appears to affect cells and other tissues that co-express ACE-2 and TMPRSS-2, including endothelial cells. Electron microscopy has indeed highlighted the presence of SARS-CoV-2 viral elements in the endothelial cells of affected organs such as the lungs, heart or kidneys.
We could then ask whether the erectile tissue of the penis, also rich in endothelial blood vessels, could also be prone to endothelial dysfunction induced by coronavirus. A small pilot study by researchers at the University of Miami suggests that it is indeed possible.
As part of this work, penile tissue was taken from patients undergoing surgery for penile prosthesis due to severe erectile dysfunction. The age of the patients ranged from 65 to 71 years old and all were of Hispanic origin. A sample was taken from two men with a history of Covid-19 infection six to eight months earlier, and from two men with no history.
Transmission electron microscopy (TEM) analyzes then highlighted the presence of extracellular viral particles with peplomers (spikes) near the vascular endothelial cells of the penis of Covid + patients. Conversely, these viral particles were absent in controls .
The expression of eNOS (a marker of endothelial function) in the corpus cavernosum of men affected by Covid was also reduced compared to controls. Finally, the average levels of endothelial progenitor cells of patients affected by the disease were significantly lower to those of men with erectile dysfunction without a history of Covid.
Note that for the first patient, other risk factors for erectile dysfunction such as hypertension, coronary artery disease and diabetes mellitus were not present. In contrast, the second sample recovered was from a patient with a significant medical history of coronary heart disease and hypertension with a relatively mild case of Covid-19 (low symptoms). Finally, both of these men had "normal erectile function" prior to their infection.
For the authors, this study is the first to demonstrate the presence of Covid in the penis long after the initial infection. “Our results also suggest that widespread endothelial cell dysfunction due to Covid-19 infection may contribute to erectile dysfunction “, can we read in conclusion.
However, these remarks should be qualified. Remember that these two people were aged 65 and 71, and that they were both of Hispanic origin. Thus, the sample in no way reflects the entire male population .
As Dr. Ash Tewari, chair of urology at the Icahn School of Medicine at Mount Sinai Hospital in New York, points out:"one or two patients don't a generality ". Also, "men shouldn't panic until more research has been done “.
