A painful, persistent erection could be a COVID-19 side effect

An erection lasting longer than four hours, just like one 62-year-old patient at the Centre Hospitalier de Versailles in Le Chesnay, France, could be a telltale sign of something larger. Before experiencing this, he had also developed the usual COVID-19 symptoms(fever, cough, severe breathing difficulties), before testing positive for SARS-CoV2. However, according to an analysis published by doctors in The American Journal of Emergency Medicine in June, there could be a connection between the two conditions.

Problems with blood circulation

A prolonged erection without sexual stimulation is known as priapism. This is considered a medical emergency because the organ cannot handle being erect for this long. It can lead to tissue damage and other irreversible consequences for the penis and its functionality. The patient was placed on an artificial respirator, sedated and fortunately, he was not in pain. Nursing staff first tried to ease his erection with an ice pack but were not successful.

Finally, blood tests revealed he had dark blood clots, symptomatic of so-called ischemic or low-flow priapism. Because it is being blocked by something, the blood is unable to flow and so cannot return to the lungs. This phenomenon can be particularly serious because it can cause the blood to stop flowing completely in the penis. As a result, doctors injected him with ethylephrine, a drug that stimulates the sympathetic nerves and relaxes the blood vessels.

Immune system and blood clots

Finally, after fourteen days, the patient was able to return home with no complications. But why did he develop blood clots when he had no prior history before he contracted COVID-19? As it turns out, and as has been previously observed in other patients, the coronavirus can cause coagulum and clots to form in the leg veins in particular (phlebitis) but also in the lungs (pulmonary embolism). But this is the first time that it has been detected in the penis.

According to Bruce Y. Lee, a health journalist for Forbes, there are three possible reasons that the coronavirus could cause blood clots:

• Because it can cause blood hyper-viscosity. To fight infection, the immunes system produces more white blood cells which consequently make the blood thicker and stickier, making blood circulation more difficult as a result;
• Because it can cause blood hyper-coagulability. Again, the chemicals produced by the immune system can encourage the blood to clot;
• Because it can cause endothelial dysfunction. The endothelium is the layer of cells that line your blood vessels and the damage this causes can also encourage blood clots to form.

It is therefore likely that COVID-19 caused this man’s unfortunate erection problem. Researchers state:

Although the arguments supporting a casual link between COVID-19 and priapism are very strong in our case, reports of further cases would strengthen the evidence.