Really hammered!

Only for medical professionals to read and reference ED may be a short-term and long-term complication of the new coronavirus, and may have a potential impact on reproductive capacity.

Recently, the journal ANDROLOGY published a study that pointed out that the risk of male erectile dysfunction (ED) caused by the new coronavirus infection has increased by nearly 6 times.

The corresponding author of the study, Dr.
Emmanuele A.
Jannini, Professor of Endocrinology and Medical Sexology at the University of Rome II, said that ED may be a short-term and long-term complication of the new crown and recommended that men receive the new crown vaccine.

The data also shows that ED is a sign of increased susceptibility to the new coronavirus.

Men with ED are more than 5 times more likely to be infected with COVID-19 than men without ED [odds ratio (OR)=5.
27].

Figure 1 Research that clarifies the various links between the new crown and male ED.
How does the new crown relate to the "happiness" of men? There are many clinical phenotypes of COVID-19, with symptoms ranging from mild to severe.

Microvascular thrombosis and inflammation caused by cytokine storm can promote the progression of pulmonary complications.

Some evidence also shows that even "silent", asymptomatic new coronary infections can cause subclinical microvascular involvement, and if things go on like this, cardiovascular sequelae may continue.

Endothelial dysfunction can not only trigger more severe clinical subtypes, but also cause different comorbidities.

In fact, the new crown can even be regarded as an endothelial disease, and its systemic manifestations may be caused by tissue ischemia caused by changes in endothelial thrombotic/fibrinolytic balance.

In addition, the endothelium also expresses many auxiliary factors that the new coronavirus needs to invade host cells.

Erectile dysfunction (ED) is a sign of endothelial dysfunction.
Therefore, it can be boldly guessed that there is a certain connection between endothelial damage caused by the new crown and ED. In addition, people have also found that there are common risk factors between ED and new coronavirus infection-hypertension, diabetes, cardiovascular disease, and obesity.
That is to say, people with any of the above factors are more likely to be ED patients, and more likely to be ED patients.
Easily infected with the new coronavirus.

How was this research done? Researchers retrieved data from the Sex COVID study and selected 100 sexually active men from the 985 Sex COVID cohort.
Among them, 25 (2.
54%) were COVID+ patients and 75 were based on age.
COVID- population matched with, BMI, Generalized Anxiety Disorder Scale (GAD-7) and Depression Screening Self-Rating Scale (PHQ-9 Score).

The Sex COVID study is an anonymous web-based questionnaire that surveys the mental, relationship and sexual health of Italians from April 7 to May 4, 2020.

The data of the study participants is shown in Table 1.
There were no statistically significant differences in age, BMI, GAD-7 and PHQ-9 scores between the two groups.
However, the researchers found that the proportion of ED in the COVID+ group was significantly higher.

Table 1 The proportion of ED in the COVID+ group was significantly higher.
The prevalence of ED in the COVID+ group (7/25, 28%) was significantly higher than that in the COVID- group (7/75, 9.
33%; p, 0.
0274) (Figure 2).

Figure 2 The incidence of ED in the COVID+ group and the COVID- group.
The Logistic regression model also confirmed that the odds ratio of ED in patients with new crown infection was 5.
66 [95%CI: 1.
50-24.
01], that is, the risk of ED in patients with new crown infection It is 5.
66 times higher than the average person.

Since ED may also be an effective clinical marker for a variety of potentially unknown diseases such as diabetes and hypertension, researchers are also measuring the risk of contracting the new crown after being diagnosed with ED.

After correcting for age, BMI, etc.
, the Logistic regression model (Table 2) showed that the odds ratio of new coronary infections for ED patients was 5.
27 [95%CI: 1.
49-20.
09].

Table 2 The odds ratio of ED patients infected with the new crown is 5.
27.
That is, the risk of infection of the new crown of the ED population is 5.
27 times higher than that of the average person. Not only does it affect "happiness", the new crown may also affect reproductive capacity.
.
.
The negative impact of the new crown virus on male reproductive capacity is another topic that has attracted much attention.

However, due to the fact that the sample size of real-world research is too small, the research takes a long time and a series of issues, this question has not been finalized yet.

However, this does not mean that the virus may affect male fertility is groundless.

Many scholars have scientifically demonstrated the possible mechanism behind this, such as the following article (Figure 3).

Figure 3 An article revealing the mechanism behind the impact of the new coronavirus on male fertility.
It is understood that the new coronavirus invades cells through the mediation between the viral spike protein (S protein) and the ACE2 receptor (Figure 4), and the ACE2 receptor It is highly expressed in testicular cells, especially in the seminiferous ducts.

Figure 4 Mechanism diagram: New coronavirus enters cells.
Wei et al.
's meta-analysis of the scRNA-seq data set shows that ACE2 is expressed in most prostate epithelial cell clusters, fibroblasts and pericytes, as well as in Leydig and Sertoli cells expression.

The report of Zhao Y et al.
showed that ACE2 is highly expressed in spermatogonia, testicular stromal cells and supporting cells, and is enriched in the latter two.

Pseudotime analysis pointed out that if spermatogonia are infected and destroyed by the new coronavirus, the spermatogenesis process will also be disrupted, and the potential of ACE2-positive Leydig and Sertoli cells to support the spermatogenesis process after infection with the new coronavirus decreases.

In addition, the author added that the expression of ACE2 is related to age.
The older the man, the greater the number of ACE2-positive cells.

In addition, the new coronavirus can affect the secretion of gonadotropins, androgens and testosterone, but the direct impact of this series of changes on male reproductive capacity is still unknown.

At the end of the article, the author pointed out that people with new crown infection who need to have a child should follow up their spermatogenesis for a long time.
He also called on people with new crown infection to include semen analysis and color Doppler ultrasound examination into routine examinations in order to find out scrotal discomfort and testicular damage in time.

For patients with abnormal semen analysis results, sex hormone levels should also be checked to assess gonad endocrine dysfunction.

In addition to vaccinating to reduce the infection rate, quitting smoking is also a way for men to guard their "happiness"! Recent studies have shown that smoking can increase the risk of new crown infection in men.

Are you surprised or surprised? We know that the new crown infection begins with the binding of the ACE2 receptor to the new crown virus S protein.
Compared with healthy subjects, the expression of ACE2 in the respiratory bronchial epithelial cells of smokers increases, which will promote the new crown virus to enter the epithelial cells and proliferate .

And the upregulation of the androgen pathway mediated by smoking will also increase the body's susceptibility to the new coronavirus.

In addition, smoking can strengthen the inflammatory factor storm caused by the new crown in the body.
For patients with new crown, the clinical manifestations and inflammatory damage of smokers are more serious than non-smokers.
This has been reported in many countries such as Iran, the United States, Japan, and Kuwait.
Proved in the queue.

Although the effects of smoking can last for several years, the benefits of quitting smoking are almost immediate.

Within 24 hours after quitting smoking, the body begins to repair tobacco-related damage.

Quitting smoking can also normalize the epithelial structure of the respiratory tract.
With the natural removal of mucus and debris in the body, the cilia of the lungs and respiratory tract will also be improved.

These benefits become more obvious within a few months after quitting smoking, and will continue to improve as the length of time to quit smoking increases.

Summary: Seeing this, I believe that the majority of men get this warning-ED may be a short-term and long-term complication of the new coronavirus, and it may have a potential impact on reproductive capacity.

In order to protect your "happiness", in addition to paying attention to daily protection against the new crown, such as gathering less, washing hands frequently, developing good living habits, and strengthening exercise to enhance immunity, you may also need to get a vaccine and quit smoking.

References: [1] Andrea Sansone, Daniele Mollaioli, Giacomo Ciocca, et al.
"Mask up to keep it up": Preliminary evidence of the association between erectile dysfunction and COVID-19.
Andrology.
https://doi.
org/ 10.
1111/andr.
13003.
[2]Mojgan Moshrefi,Saeed Ghasemi-Esmailabad,Jaffar Ali,et al.
The probable destructive mechanisms behind COVID-19 on male reproduction system and fertility.
Assist Reprod Genet.
2021 May 11:1–18.
[3]Wei X,Xiao YT,Wang J,Chen R,Zhang W,Yang Y,Lv D,Qin C,Gu D,Zhang B.
Sex differences in severity and mortality among patients with COVID-19:evidence from pooled literature analysis and insights from integrated bioinformatic analysis.
arXiv preprint arXiv:200313547.
[4]Zhao Y,Zhao Z,Wang Y,Zhou Y,Ma Y,Zuo W.
Single-cell RNA expression profiling of ACE2,the putative receptor of Wuhan 2019 -nCov.
10.
1101/2020.
01.
26.
919985[5]Wang Z,Xu X,et al.
Cells.
2020;9(4):920.
doi:10.
3390/cells9040920.
[6]Gupta AK,Nethan ST,Mehrotra R,Tobacco use as a well-recognized cause of severe COVID-19 manifestations.
Respir Med 2021 01;176.