(072) Comparing Risk of Post-Infection Erectile Dysfunction Following SARS Coronavirus 2 Stratified by Acute and Long COVID, Vasopressor Administration, and Hospitalization Status

Abstract

Abstract Introduction While multiple studies have shown an association between acute COVID-19 infection and subsequent development of erectile dysfunction (ED), no study has yet assessed the risk of developing ED after a diagnosis of long COVID. It is unclear if there is an increased risk of ED in those with long COVID compared to only those diagnosed with acute COVID. In addition, the impact of vasopressor use and hospitalization for an acute COVID infection on ED development is uncertain. Objective This study sought to assess the risk of ED in individuals with acute COVID-19 when compared to individuals with long COVID-19, as well as risk of ED following more severe cases requiring vasopressors and hospitalization. Methods The TriNetX COVID-19 Research Network was queried from December 1st 2020 through June 2023. We included men aged ≥ 18-years old and analyzed cohorts comparing the following 1) men diagnosed with long COVID-19 (ICD-10: U09) were compared to those that were diagnosed with or had positive test for acute COVID-19 but no diagnosis of long COVID. Men were included if they had at least one outpatient follow-up visit 2 weeks after the initial positive test result and excluded if they received a prior ED diagnosis or treatment, prostatectomy, pelvis radiation, or pulmonary hypertension diagnosis at any time. Additional analyses were performed with the same above criteria including men that were and were not hospitalized within 1 month of acute COVID diagnosis and whether men needed vasopressors or not. Cohorts were propensity score matched and compared for differences in new ED diagnosis and/or prescription of phosphodiesterase-5 inhibitors (PDE5i). Variables on which propensity scores were matched are detailed in Table 1. Results A total of 2839 men were included in each cohort after propensity score matching with an average age of 54.5 +/- 16.7 years and 55.1 +/- 17.1 years in the long and acute COVID cohorts, respectively. Men diagnosed with long COVID-19 were more likely to develop ED or be prescribed PDE5i (3.63%) when compared to men with only acute COVID-19 infections (2.61%) [RR 1.39; 95% CI 1.04, 1.87]. There was no statistically significant increased or decreased risk of developing ED or being prescribed PDE5i for individuals who received vasopressors [RR 0.922; 95% CI 0.774,1.098] or were hospitalized [RR 0.933; 95% CI 0.824,1.056]. Conclusions We found that long COVID-19 infection was associated with greater risk for ED diagnosis or PDE5i prescriptions when compared with men diagnosed with only an acute COVID-19 infection, while there was no significantly increased risk for individuals requiring vasopressors or hospitalization. Disclosure No.