Estimating the global prevalence of erectile dysfunction during the COVID-19 pandemic.

The article of Adeyemi et al. [1] concluded that coronavirus disease 2019 (COVID-19) may detrimentally interplay with the male reproductive system during acute infection and recovery, leading to a substantial risk of developing erectile dysfunction. Since impotence is a major source of physical (i.e. impossibility to procreate) and psychological issues, we carried out an infodemiological analysis to estimate the potential worldwide burden of erectile dysfunction before and during the COVID-19 pandemic in order to provide further insights on this important matter. We accessed Google Trends (Google Inc. Mountain View, CA, USA) with the keyword “erectile dysfunction” as “medical condition” (and thereby overcoming potential language barriers), setting the geographical location to “worldwide,” and limiting our analysis to the past 5 years (i.e. from July 2017 to July 2022). The weekly Google Trends score for the search term reflects its potential worldwide popularity and prevalence [2], was divided in two periods, as “pre-COVID” (from July 2017 to February 2020) and “COVID” (from March 2020 to July 2022), to generate two representative and nearly overlapping time windows. The difference between such periods was analysed with Mann–Whitney test (Analyse-it Software Ltd, Leeds, UK). The study was conducted in accordance with the Declaration of Helsinki, under the terms of relevant local legislation. Our analysis encompassed an electronic search in an open and publicly available repository (Google Trends), so that no informed consent or Ethical Committee approval were necessary. The results of our analysis are summarized in Figure 1. During the COVID-19 pandemic the worldwide volume of Google searches for “erectile dysfunction” has gradually increased over time, displaying a median value (interquartile range; IQR) of 80 (IQR, 78–83) during this period, which was 8.1% higher compared to the pre-COVID period (median, 74; IQR, 71–76; p< 0.001). In conclusion, the results of this infodemiological analysis seemingly support the conclusion of Adeyemi et al. [1], that erectile dysfunction may be another less predictable but certainly unwarranted consequence of COVID19, which may also justify the decreased sexual healthseeking behaviours reported by Sansone et al. [3]. This is not really surprising considering that erectile dysfunction and COVID-19 share some important predisposing and contributing factors such as impairment of vascular integrity, cardiovascular dysfunction and inflammation [1]. Therefore, major efforts shall be made to raise public awareness on this unfavourable association, for allowing timely diagnosis and early treatment of erectile dysfunction potentially developing after SARS-CoV-2 infection.