62-year-old Covid-19 patient has an erection for four hours, doctors suspect blood clots are to blame
A Covid-19 patient in his 60s suffered an odd symptom: an erection that lasted four hours, according to a case study. Doctors treating him suspect that the new coronavirus may have triggered blood clots in his penis, leading to the man's woes. The erection was painful and unrelated to sexual interest or stimulation. It is, in fact, a medical condition called priapism, which tends to affect people with sickle cell anemia, a disorder caused due to abnormal blood vessels. If untreated, it could lead to erectile dysfunction.
Evidence "strongly suggests priapism related to Covid-19 infection. This medical emergency should be recognized by healthcare professionals and treated promptly to prevent immediate and chronic functional complications," the study authors said.
The connection between Covid-19 and blood clots is not new. The lungs of the patients who succumbed to the disease showed clots. Some patients have developed strokes and heart damage due to the lumps blocking blood vessels. Others have had Covid-19 toes. According to one study, out of 184 patients in the ICU, over 30% showed some form of clotting issue. "The number of clotting problems I'm seeing in the ICU [intensive care unit], all related to COVID-19, is unprecedented," Dr. Jeffrey Laurence, a hematologist at Weill Cornell Medicine in New York City, told CNN.
This is the first time scientists have detected a blood clot in the penis. The patient in question was a 62-year-old man from France. He sought medical help after experiencing symptoms such as physical weakness, fever, dry cough, and diarrhea. Suspecting a bacterial infection, his doctor prescribed him an antibiotic. Within two days, the man's condition worsened due to breathing discomfort. He was taken to the hospital.
Once at the hospital, the man was hooked to a ventilator to support breathing. When doctors physically examined him, they realized he had priapism. His tests for Covid-19 came back positive. Doctors placed an ice pack to ease the erection — but it did not work. Puzzled, the team extracted blood from the penis and found dark blood clots in the organ.
Further examination revealed that the man had ischemia-related priapism. It happens when blood cannot leave the penis. Blood clots may have blocked the blood from leaving the organ, leading to a prolonged erection. What is more, there was an excess accumulation of carbon dioxide in his blood. This could be due to clots blocking fresh oxygen-infused blood from reaching the penis.
To treat the erection, the doctors injected Ethylephrine — a drug known to relax blood vessels — into his penis. They also administered a blood thinner called enoxaparin to stave off further blood clots. After two weeks of mechanical ventilation, the patient recovered. Doctors are unsure about the connection between blood clots and Covid-19. But they speculate that an overreaction from the immune system has a role to play in it.
The researchers have called for more studies on the topic. "Although the arguments supporting a causal link between Covid-19 and priapism, as well as the ischemic mechanism for priapism, are very strong in our case, reports of further cases would strengthen the evidence," they said. The study is published in the American Journal of Emergency Medicine.