Covid-19 may cause priapism ― an erection lasting longer than four hours, doctors have warned.
An unidentified 62-year-old man from France suffered a painful condition while receiving care in hospital for a severe bout of the coronavirus.
His erection was caused by trapped blood in the penis, which was found to be full of blood clots when it was drained by medics.
Blood clotting, or thrombosis, has been reported as a dangerous complication in up to a third of coronavirus-infected patients.
When clots block arteries or veins, the blockages can trigger fatal heart attacks and strokes. They can also lead to pripiasm.
But this is believed to be the first time priapism has been seen as a side effect of the coronavirus, which has killed 500,000 people worldwide.
The patient left intensive care after spending two weeks on a ventilator, suggesting he has now recovered from Covid-19.
Doctors at Centre Hospitalier de Versailles in Le Chesnay, an area near Paris, wrote about the man in The American Journal of Emergency Medicine.
Myriam Lamamri, an intensive care doctor, explained how blood clotting caused by Covid-19 has been extensively reported during the pandemic.
Normally, blood clotting occurs when someone injures themselves. The clot stops a wound, such as a paper cut, from bleeding.
This process can happen at the wrong time, causing thrombosis – when blood clots develop in the arteries and veins. These clots block the heart, brain and lungs.
Hospital patients with Covid-19 are suffering blood clots but doctors are mystified as to why.
Some say the virus is directly causing their blood to change. Another theory is that the virus’s effects on the immune system could also ramp up clotting through a variety of pathways.
Dr Lamamri said this is the first time ‘penile thrombosis’ has been reported in a patient with Covid-19.
The patient to his doctor with a fever, dry cough, difficulty breathing and diarrhoea, and two days later was rushed to hospital where a test confirmed the coronavirus.
On arrival he was mechanically ventilated because he was showing signs of respiratory failure, called ARDS.
A physical examination found ‘previously unidentified priapism’, suggesting it had been there for some time.
The two corpora cavernosa ― the chambers of tissue inside the penis ― were rigid. But the tip was flaccid.
The man suffered low-flow priapism ― when blood becomes trapped in the erection chambers ― as opposed to high-flow priapism, caused by injury.
It can often occur without a known cause in men who are otherwise healthy. It also affects men with sickle-cell disease, leukemia (cancer of the blood), or malaria.
The man was sedated and so he was unable to answer questions about how much pain he was suffering ― but the condition is known to become excruciating.
An ice pack was applied to the penile area. After four hours of a persistent erection, doctors sucked out the blood from his penis using a needle.
They found ‘dark blood clots’ which they said were the result of thrombosis induced by the coronavirus.
The doctors came to this conclusion because no other alternative cause of priapism was found and the virus is known to cause blood clotting complications.
They wrote: ‘Although the arguments supporting a causal link between COVID-19 and priapism are very strong in our case, reports of further cases would strengthen the evidence.
‘The clinical and laboratory presentation in our patient strongly suggests priapism related to SARS-CoV-2 infection.’
Any form of priapism can cause long-term damage, and therefore needs to be treated as quickly as possible.
As well as draining the blood from the penis, the doctors injected the man with drugs to normalise his nervous system and he was given medication to prevent blood clotting.
He hasn’t suffered priapism since leaving hospital, the report said.
Dr Richard Viney, a consultant urological surgeon at the Queen Elizabeth Hospital in Birmingham, said this case was ‘interesting’ and he hadn’t come across any Covid-19 patients with priapism himself.
He told MailOnline: ‘We haven’t seen any cases of Covid-related priapism like this and we have dealt with more Covid patients than any other European hospital as far as I’m aware, so this is clearly a rare but explainable manifestation of Covid.
‘Although the article doesn’t go into detail on his follow up I would suspect a high likelihood of profound erectile failure after this event which is unlikely to respond to medication. He would likely require a penile prosthesis insertion should he want to maintain his potency.
‘In this patient, he has low flow priapism which would certainly fit with microemboli (little clots forming in smaller blood vessels) and this is one of the complications of Covid we see in many other organ systems.’
Dr Viney said an alternative explanation might be profound hypoxia – deprivation of oxygen.
This is seen in males who die by hanging, who have erections after their death, attributed to pressure on the cerebellum at the base of the brain created by the noose.
It has been given the nicknames ‘Angels Lust’ or the ‘Terminal Erection’.
Source: Daily Mail
