The effects of social isolation measures taken against the COVID-19 pandemic on erectile functions of healthcare professionals: a prospective comparative study

Abstract

Objective: In this study, we aimed to investigate whether the anxiety caused by the COVID-19 pandemic on healthcare professionals with different duties, such as doctors, nurses, medical secretaries, and medical staff, causes erectile dysfunction (ED).
Material and Methods: In between 1 May 2020 and 1 August 2020, volunteering male health workers who had regular sexual intercourse at least once a week for the last six months and who had not previously worked in COVID-19 clinics were included in the study. Before and 4 weeks after working in COVID-19 clinics, erectile function was determined by the International Index of Erectile Function-5 (IIEF-5) form. The Hamilton Anxiety Rating Scale (HAS) was used to evaluate anxiety disorders and their severity.
Results: A total of 218 male health caregivers were included in the study. Among these, 56 (25.7%) were doctors, 81 (37.2%) were nurses, 46 (21.1%) were medical secretaries and 35 (16.1%) were the medical staff. The mean HAM-A score of the doctors measured 4 weeks after having worked in a COVID-19 clinic (3,32±4,68) was observed to be significantly higher compared to that measured before working (28,43±14,05) (p<0.001). The mean IIEF-5 scores of the doctors measured 4 weeks after having worked in a COVID-19 clinic (16,34±4,11) was observed to be significantly lower compared to that measured before working (22,29±2,35) (p<0.001).
Conclusion: Our results indicate that healthcare professionals working in COVID-19 clinics have increased anxiety and ED, and physicians are affected more than the other healthcare professionals. 

Keywords

• COVID-19
• Health Caregivers
• Erectile Dysfunction
• Anxiety
• Hamilton Anxiety Scale

COVID-19 pandemisine karşı alınan sosyal izolasyon önlemlerinin sağlık çalışanlarının erektil fonksiyonları üzerine etkileri: prospektif karşılaştırmalı bir çalışma

Abstract

Amaç: Bu çalışmada, COVID-19 pandemisinin doktor, hemşire, tıbbi sekreter, hastane personeli gibi farklı görevlerde bulunan sağlık çalışanları üzerinde yarattığı kaygının erektil disfonksiyona (ED) neden olup olmadığını araştırmayı amaçladık. Gereç ve Yöntemler: 1 Mayıs-1 Ağustos 2020 tarihleri arasında, son altı aydır haftada en az bir kez düzenli cinsel ilişkide bulunan ve daha önce COVID-19 kliniklerinde çalışmamış gönüllü erkek sağlık çalışanları çalışmaya dahil edildi. COVID-19 kliniklerinde çalışmadan önce ve çalışmaya başladıktan 4 hafta sonra, erektil fonksiyon Uluslararası Erektil Fonksiyon İndeksi-5 (IIEF-5) formu ile belirlendi. Anksiyete bozukluklarını ve şiddetini değerlendirmek için ise Hamilton Anksiyete Derecelendirme Ölçeği (HAM-A) kullanıldı. Bulgular: Çalışmaya toplam 218 erkek sağlık çalışanı dahil edildi. Bunların 56'sı (%25,7) doktor, 81'i (%37,2) hemşire, 46'sı (%21,1) tıbbi sekreter ve 35'i (%16,1) sağlık personeliydi. Doktorların, COVID-19 servislerinde çalıştıktan 4 hafta sonra ölçülen HAM-A puanının (3,32±4,68), COVID-19 servislerinde çalışmadan önce ölçülen ortalama HAM-A puanına (28,43±14,05) göre anlamlı düzeyde yüksek olduğunu tespit ettik (p<0.001). Doktorların, COVID-19 servislerinde çalıştıktan 4 hafta sonra ölçülen ortalama IEEF-5 puanlarının (16,34±4,11), COVID-19 servislerinde çalışmadan önce ölçülen ortalama IEFF-5 puanına (22,29±2,35) göre anlamlı düzeyde düşük olduğunu tespit ettik (p<0.001). Sonuç: Sonuçlarımız COVID-19 kliniklerinde çalışan sağlık çalışanlarının anksiyete ve ED düzeylerinin arttığını ve bu durumdan doktorların diğer sağlık çalışanlarına göre daha fazla etkilendiğini göstermektedir.

Keywords

• COVID-19
• Sağlık çalışanları
• Erektil disfonksiyon
• Anksiyete
• Hamilton Anksiyete Ölçeği

References

1. 1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. https://doi.org/10.1056/NEJMoa2001017
2. 2. Li H, Liu SM, Yu XH, et al. Coronavirus disease 2019 (COVID-19): current status and future perspectives. Int J Antimicrob Agents. 2020;55(5):105951. https://doi.org/10.1016/j.ijantimicag.2020.105951
3. 3. Jacob L, Smith L, Butler L, et al. COVID-19 Social Distancing and Sexual Activity in a Sample of the British Public. J Sex Med. 2020;17(7):1229-1236. https://doi.org/10.1016/j.jsxm.2020.05.001
4. 4. Wang C, Horby PW, Hayden FG, et al. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223):470–473.
5. 5. COVID-19 coronavirus pandemic. In: Worldometers website. https://www.worldometers.info/coronavirus/. Accessed 5 May 2022
6. 6. Schiavi MC, Spina V, Zullo MA, et al. Love in the Time of COVID-19: Sexual Function and Quality of Life Analysis During the Social Distancing Measures in a Group of Italian Reproductive-Age Women. J Sex Med. 2020;17(8):1407-1413. https://doi.org/10.1016/j.jsxm.2020.06.006
7. 7. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993;270(1):83–90.
8. 8. Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates: Results of the Massachusetts Male Aging Study. J Urol. 1994;151(1):54–61. https://doi.org/10.1016/S0022-5347(17)34871-1

9. 9. Gratzke C, Angulo J, Chitaley K, et al. Anatomy, physiology, and pathophysiology of erectile dysfunction. J Sex Med. 2010;7(1 Pt 2):445–475. https://doi.org/10.1111/j.1743-6109.2009.01624.x
10. 10. Liu Q, Zhang Y, Wang J, et al. Erectile Dysfunction and Depression: A Systematic Review and Meta-Analysis. J Sex Med. 2018;15(8):1073–1082. https://doi.org/10.1016/j.jsxm.2018.05.016
11. 11. Sugimori H, Yoshida K, Tanaka T, et al. Relationships between erectile dysfunction, depression, and anxiety in Japanese subjects. J Sex Med. 2005;2(3):390–396. https://doi.org/10.1111/j.1743-6109.2005.20354.x
12. 12. Liu X, Luo WT, Li Y, et al. Psychological status and behavior changes of the public during the COVID-19 epidemic in China. Infect Dis Poverty. 2020;9(1):58. https://doi.org/10.1186/s40249-020-00678-3
13. 13. González-Sanguino C, Ausín B, Castellanos MÁ, et al. Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain. Brain Behav Immun. 2020;87:172-176. https://doi.org/10.1016/j.bbi.2020.05.040
14. 14. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. https://doi.org/10.3390/ijerph17051729
15. 15. Pappa S, Ntella V, Giannakas T, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907. https://doi.org/10.1016/j.bbi.2020.05.026
16. 16. Turunç T, Deveci S, Güvel S, et al. The assessment of Turkish validation with 5 question version of International Index of Erectile Function (IIEF-5). Turk J Urol. 2007;33(1):45–49.
17. 17. Yazıcı M, Demir B, Tanrıverdi N, et al. Hamilton Anxiety Rating Scale: Interrater Reliabilty and Validity Study. Türk Psikiyatr Derg. 1998;9(2):114–120.
18. 18. Matza LS, Morlock R, Sexton C, et al. Identifying HAM-A cutoffs for mild, moderate, and severe generalized anxiety disorder. Int J Methods Psychiatr Res. 2010;19(4):223–232. https://doi.org/10.1002/mpr.323
19. 19. Jern P, Gunst A, Sandnabba K, et al. Are early and current erectile problems associated with anxiety and depression in young men? A retrospective self-report study. J Sex Marital Ther. 2012;38(4):349–364. https://doi.org/10.1080/0092623X.2012.665818
20. 20. Hale VE, Strassberg DS. The role of anxiety on sexual arousal. Arch Sex Behav. 1990;19(6):569–581. https://doi.org/10.1007/BF01542466
21. 21. Preti E, Di Mattei V, Perego G, et al. The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep. 2020;22(8):43. https://doi.org/10.1007/s11920-020-01166-z.
22. 22. Bai YM, Lin CC, Lin CY, et al. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004;55(9):1055–1057. https://doi.org/10.1176/appi.ps.55.9.1055.
23. 23. Styra R, Hawryluck L, Robinson S, et al. Impact on health care workers employed in high-risk areas during the Toronto SARS outbreak. J Psychosom Res. 2008;64(2):177–183. https://doi.org/10.1016/j.jpsychores.2007.07.015
24. 24. Lai J, Ma S, Wang Y, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
25. 25. Koksal E, Dost B, Terzi Ö, et al. Evaluation of Depression and Anxiety Levels and Related Factors Among Operating Theater Workers During the Novel Coronavirus (COVID-19) Pandemic. J Perianesthesia Nurs. 2020;35(5):472-477. https://doi.org/10.1016/j.jopan.2020.06.017
26. 26. Lu W, Wang H, Lin Y, et al. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Res. 2020;288:112936. https://doi.org/10.1016/j.psychres.2020.112936
27. 27. Culha MG, Demir O, Sahin O, et al. Sexual attitudes of healthcare professionals during the COVID-19 outbreak. Int J Impot Res. 2021;33(1):102–109. https://doi.org/10.1038/s41443-020-00381-9
28. 28. Güzel A, Döndü A. Changes in sexual functions and habits of healthcare workers during the ongoing COVID-19 outbreak: a cross-sectional survey study. Ir J Med Sci. 2021;1–9. https://doi.org/10.1007/s11845-021-02691-3
29. 29. De Rose AF, Chierigo F, Ambrosini F, et al. Sexuality during COVID lockdown: a cross-sectional Italian study among hospital workers and their relatives. Int J Impot Res. 2021;33(1):131-136. doi:10.1038/s41443-020-00393-5
30. 30. Bulut EC, Ertaş K, Bulut D, et al. The effect of COVID-19 epidemic on the sexual function of healthcare professionals. Andrologia. 2021;53(3):e13971. https://doi.org/10.1111/and.13971
31. 31. Eroglu U, Balci M, Coser S, et al. Impact of the COVID-19 Pandemic on the Psychosexual Functions of Healthcare Workers. J Sex Med. 2022;19(2):182-187. doi:10.1016/j.jsxm.2021.11.013
32. 32. Bakr AM, El-Sakka AI. Erectile dysfunction among patients and health care providers during COVID-19 pandemic: A systematic review. Int J Impot Res. 2022;34(2):145-151. doi:10.1038/s41443-021-00504-w