• Doctors said the patient experienced ischemic priapism
  • The erection eventually subsided after doctors drained the blood from the man's penis
  • It is said to be a "rare" manifestation of COVID-19

A patient with severe COVID-19 developed a rare complication – he experienced a 3-hour erection.

The 69-year-old patient from Ohio was taken to the emergency room after displaying respiratory symptoms for a week, a case report, published in the American Journal of Emergency Medicine earlier this year, said.

He tested positive for COVID-19 and his condition continued to worsen. Doctors intubated him and placed him on a ventilator. He was sedated using propofol and fentanyl, and was also positioned to lie on his stomach to help him breathe, noted.

The next afternoon, while adjusting the patient's position, a nurse noticed that the man had an erection. It persisted even after they placed ice packs on the region and it lasted for over three hours.

The erection eventually subsided after doctors drained the blood from the man's penis and administered medication. Although it did not reoccur, the man died.

What is priapism?

Priapism is a condition wherein a person experiences "persistent and sometimes painful" erections without sexual stimulation, the University of California San Francisco (UCSF) Health explained.

There are three subtypes of priapism, and the authors noted that the patient experienced ischemic priapism. This is when the blood becomes stuck in the erection chamber. It is considered a medical emergency that requires immediate treatment, UCSF Health said, noting that it could cause scar tissue or even impotence if left untreated.

'Rare' COVID-19 manifestation

So what caused the priapism in the patient? It was possibly a "thromboembolic complication" of severe COVID-19. Such complications happen when a blood clot "breaks loose" and causes a block in another blood vessel, noted.

The researchers say such thromboembolic complications occur quite frequently in COVID-19 patients.

"In a study of 3,334 patients in New York City, Bilaloglu et al. observed a 16% rate of thrombosis, 29.4% in ICU patients, using routine screening practices," they wrote.

Priapism, however, is considered uncommon.

Urological surgeon Dr. Richard Viney, of Queen Elizabeth Hospital in Birmingham, the U.K., said it was a "rare but explainable manifestation of COVID."

"In this patient, he had 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 told the Daily Mail.

COVID-19-related erection

This was not the first such case. In 2020, doctors also reported the case of a 62-year-old COVID-19 patient who suffered a four-hour erection while on the ventilator.

"The clinical and laboratory presentation in our patient strongly suggests priapism related to SARS-CoV-2 infection," they said at the time, noting that it should be treated immediately to prevent complications. The patient survived the ordeal after being on the ventilator for 14 days.

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