Coronavirus: Can Covid lead to impotence?

Some studies find higher rates of erectile dysfunction among men recovering from the illness.

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A patient with long Covid being examined in a hospital in Israel.Amir Cohen/Reuters

Can Covid lead to erectile dysfunction?

Hundreds of papers by scientists in Europe and North America, as well as in Egypt, Turkey, Iran and Thailand, point to yes. But the estimates of the magnitude of the problem vary wildly, my colleague Roni Caryn Rabin reports.

Researchers at the University of Miami's Desai Sethi Urology Institute found that the risk of erectile dysfunction increased by 20 percent after a bout with Covid. Other investigators have reported even higher increases.

Research from imaging scans and biopsies indicates that the coronavirus can infect tissue within the male genital tract, where it may linger. But scientists say it may be too soon to be certain about a link, because so many factors — psychological as well as physiological — play a role in producing and maintaining an erection. The pandemic has led to social isolation and a surge in anxiety and depression, all of which may play a role.

"Men's erections are more complicated than people think," said Dr. Justin Dubin, who co-wrote a paper about the adverse impact of Covid on men's health. Blood flow and good hormone levels are important, he said, "but you also need to be in a good state of mind, and you also need to be aroused. If any of these things go wrong, you may have an issue getting an erection."

In that sense, experts say the pandemic is the perfect confluence of converging factors that can cause erectile dysfunction.

Some researchers speculate that erectile dysfunction may be linked to the well-documented loss of the ability to taste and smell experienced by Covid patients, because these senses play an important role in sexual arousal.

At the very least, men need healthy blood vessels and good blood flow in order to develop and sustain erections, and the coronavirus may damage the circulatory system. Injury to blood vessels may also contribute to more serious complications of Covid, like heart attacks, strokes and abnormal clotting.

"Our entire vascular system is connected — it's not an isolated penis problem," said Dr. T. Mike Hsieh, director of the men's health center at the University of California, San Diego. Erectile dysfunction can resolve on its own, but Dr. Hsieh encouraged men with symptoms to see their physicians, and sooner rather than later.

"If you're having these problems, do not wait," he said. "For the most part, we can get the guys' sex lives back."

Hospitalizations are trending in the wrong direction.Dave Sanders for The New York Times

A coming strain on hospitals?

Hospitalizations are rising again in the U.S., and experts are worried about the potential to strain the health care system.

As of Wednesday, an average of nearly 18,000 people with the coronavirus were in American hospitals, an increase of almost 20 percent from two weeks ago. That includes patients who were admitted for other reasons who tested positive on arrival.

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The influx has been even steeper in hot spots, like the one that began in upstate New York and spilled into nearby states. There were 2,119 patients hospitalized in the state with Covid on Tuesday, 47 percent more than two weeks ago.

The figure is still well below the winter Omicron peak of January, when about 13,000 people were hospitalized statewide, but it has been increasing, propelled by rapidly spreading BA.2 subvariants. At the same time, hospitals are struggling with staffing shortages and a recent increase in infections among their staffs.

"Covid is here, Covid is an issue," said Michael Stapleton, the chief executive at F.F. Thompson Hospital in Canandaigua, N.Y. "But the main challenge up here is the staffing."

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What you're doing

I baked chocolate chip cookies with my son this evening. It's so interesting how memories can be very sensory driven. My first bite was such an overwhelming sense of "yum, this tastes like quarantine." Yeah, we baked a lot of cookies when we were in our Covid bubble, which we've now come out of for the most part since everyone in the house except me had Omicron in January.

— Jenny Wilkinson, Dallas

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