الفهرس 
Title : Effect of COVID-19 infection on penile circulation during the first year after surviving COVID-19 infection: a cohort study
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Abstract
Background: corona virus disease 2019) COVID-19(is caused by a
previously unknown beta-corona virus which is now named SARS-CoV-
2 due to its high sequence similarity (" ~ "80%) with SARS-CoV.
Aim and objectives; Evaluate the effect of COVID-19 infection
on penile circulation in terms of penile duplex and IIEF.
Subjects and methods: This study was carried on male patients
recovered from covid 19 infection. The participants were 114 men
aged 21 years and older (married individuals with regular coital
relations) who had positive COVID-19 polymerase chain reaction
(PCR) test and were treated for COVID-19 disease. Covid 19
cases were subdivided according to severity of covid symptoms
into mild, moderate, severe and critical : number of mild cases 72,
number of moderate cases 33, number of severe cases 14 and
number of critical cases 0. The study did not include patients with
a history of previous prostate or urethral surgery, patients with any
chronic illness that might be a cause of ED or who had previously
received surgical or medical treatment for ED. All patients were
subjected to International Index of Erectile Function (IIEF), PHQ-
9 (Patient Health Quetionnaire-9), GAD-7 (General Anxiety Disorder-7)
and penile duplex (only if IIEF showed mild, moderate or severe
ED). Follow up was carried out at three and six months intervals
using the same assessment tools mentioned before.
Result:
Our data showed that 71 (62.3%) had mild symptoms, 32 (28.1%)
IX
patients had moderate symptoms, while 11 (9.6%) patients had severe COVID-19
disease. the prevalence of ED at time of presentation was 35.1% according to results
of IIEF-5 score. PHQ-9 assessment at baseline of the included patients showed that
34.2% had depression versus 14% at 3 months of follow up, and 12.3% at 6 months of
follow up. GAD-7 assessment at baseline showed that Anxiety was reported in 29.9%
of the included patients, versus 16.7% at 3 months and 14% at 6 months.
PHQ-9, GAD-7 and IIEF-5 scores at presentation versus after 3 months and 6 months
follow up showed that there was a statistically significant improvement in PHQ-9,
GAD-7 and IIEF-5 scores between first presentation and subsequent visits with p
value <0.001 all. severity of COVID-19 infection was positively correlated with IIEF-
5 and PHQ-9 at presentation with r=0.249, 0.241 and p values 0.008, and 0.010
respectively. All patients who had any degree of ED underwent penile duplex, they
were 40 patients at presentation, 5 patients at 3 months and 3 patients at 6 months,
penile duplex didn‘t elicit any organic cause for ED among patients with persistent
ED (All patients showed normal penile duplex parameters with normal ,majority of
the cases, or fair clinical response).
Conclusion:
We finally concluded that erectile dysfunction, anxiety and depression are commonly
associated with COVID-19 infection. ED was positively correlated with severity of
COVID-19 infection. ED associated with COVID-19 infection is mainly of mild
severity and mostly resolve by standard of care treatment. IIEF-5 score was
negatively correlated with the PHQ-9 and GAD-7 scores.