Authors of the case report are warning other health care professionals to look out for this rare complication.

By Korin Miller
July 02, 2020
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COVID-19 has reportedly caused some unusual side effects—the loss of taste and smell, COVID toes, skin rashes—but there are plenty of symptoms associated with coronavirus we’re still learning about. Case in point: One man with a severe case of the virus who ended up suffering from a four-hour erection.

The 62-year-old man, who has not been publicly identified, is now the subject of a new case report published June 18 in The American Journal of Emergency Medicine. Experts are using his case to warn others that priapism—a medical condition where the penis stays erect for longer than usual outside of sexual stimulation—is a potential side effect of the virus.

According to the case report, the man went to Centre Hospitalier de Versailles in Le Chesnay near Paris with complaints of having symptoms like a fever, dry cough, diarrhea, and generally feeling sick. Doctors gave him antibiotics, but he went back to the hospital two days later after he experienced shortness of breath. The man went into respiratory failure, had to be put on a ventilator, and was treated for acute respiratory distress syndrome (ARDS).

The man had to be sedated and was unconscious when he was put on the ventilator. Afterward, doctors conducted a physical exam that discovered “previously unidentified priapism, in the absence of urinary catheterization." The man was also tested for COVID-19 upon arrival to the hospital, the results of which were positive for a SARS-CoV-19 infection.

While priapism can go away on its own, it can also be a medical emergency, according to the American Urological Association. And, if it persists, it can lead to sexual dysfunction in the future. Depending on the type of priapism someone experiences, it can also be painful. (The man in the case report experienced low-flow priapism, which happens when blood flows into the penis but is unable to flow out.) Given that he was sedated at the time, doctors didn’t know if he was in pain.

Priapism isn’t super common, but it happens enough. The condition sent approximately 8,700 men to emergency rooms in the U.S. over a three-year period, according to a 2013 study published in the Journal of Sexual Medicine.

Doctors tried to apply an ice pack to the man’s penis, but he still had an erection after four hours. At that point, doctors decided to suck the blood from his penis with a needle—it was then that they discovered he had blood clots in his penis. Blood clots in general are a potentially dangerous side effect of COVID-19 and have been found in numerous patients with coronavirus, though experts are still unsure why.

The unidentified man was on a ventilator for two weeks and has reportedly recovered, after being discharged from the ICU. According to the case report, he did not have any more blood clots in his penis or anywhere else in his body during the remainder of his time in the hospital.

Though more research is needed, the case report’s authors are urging other medical staff to look out for this complication. “The clinical and laboratory presentation in our patient strongly suggests priapism related to SARS-CoV-2 infection,” they wrote. “This medical emergency should be recognized by healthcare professionals and treated promptly to prevent immediate and chronic functional complications.”

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDCWHO, and their local public health department as resources.

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