(682) COVID-19 and Male Sexual Health: A Systematic Review of Erectile Dysfunction — Prevalence, Mechanistic Insights and Risk Factor Analysis

Introduction Since December 2019, the coronavirus disease 2019 (COVID-19) pandemic has caused profound global morbidity and mortality. Beyond its acute respiratory manifestations, attention has turned to long-term systemic complications. Emerging reports indicate that male sexual and reproductive health may be affected, with erectile dysfunction (ED) identified as a potential post-COVID sequela. Objective The SARS-CoV-2 pandemic has revealed multiple post-infectious sequelae, among which erectile dysfunction (ED) has gained increasing attention. This review evaluates the prevalence of ED among COVID-19 survivors, explores possible biological and psychosocial mechanisms, and summarizes current evidence on associated risk factors Methods A systematic review was conducted using PubMed, Embase, and Cochrane Library databases up to April 2022. Studies reporting ED in adult men following confirmed COVID-19 infection were included. Data on prevalence, diagnostic method, risk factors, and proposed pathophysiological mechanisms were extracted. Results Eight studies (four with control groups) involving approximately 250,000 COVID-19 patients and more than 10 million controls met inclusion criteria. The pooled prevalence of ED was 33 % (95 % CI 18–47 %), varying according to diagnostic tool: 9 % by ICD-10 code and 46 % by IIEF-5 questionnaire. The pooled relative risk of ED among COVID-19 survivors compared with non-infected controls was 2.64 (95 % CI 1.01–6.88). Anxiety emerged as a significant risk factor (OR 1.13; 95 % CI 1.03–1.26). Conclusions This systematic review demonstrates a consistent association between COVID-19 infection and subsequent erectile dysfunction. The pooled prevalence of approximately 33% and a 2.6-fold increased risk compared with non-infected controls underscore a clinically relevant impact on male sexual health. Disclosure No