Effects of Previous COVID-19 Infection Experience on Sexual and Reproductive Health in the Chinese Population: An Online Cross-Sectional Survey Study (Preprint)
Authors: Xu Chuan , Geng Hao , Wang Chao , Shen Qunshan , Zhang Junfei , Lv Mingrong , Li Kuokuo , Li Guanjian , He Xiaojin , Tang Dongdong , Jiang Hui , Zhang Xiansheng 
Published: May 2023

BACKGROUND

Coronavirus disease 2019 (COVID-19) has been now better understood, and multiple complications resulting from COVID-19 infection were confirmed. However, clinic evidence for post-COVID-19 sequelae is still lacking, including sexual and reproductive health.

OBJECTIVE

We aimed to evaluate the effects of previous COVID-19 infection experience on sexual and reproductive health among Chinese population.

METHODS

From February 20 to 25, 2023, a total of 4,000 Chinese married individuals aged 20-40 years were enrolled through internet platform to complete questionnaires, including demographics (e.g., ethnicity, age, education, etc.), with or without COVID-19, recovery time from COVID-19 (if infection), premature ejaculation diagnostic tool (PEDT) and International Index of Erectile Function-5 (IIEF-5) (for male), female sexual function index (FSFI) (for female), as well as reproductive information (e.g., childbearing history, pregnancy planning). Univariate analysis and multivariate logistic analysis were applied to identify the correlation between COVID-19 and sexual/reproductive health data.

RESULTS

Finally, a total of 1575 eligible respondents (39.4%) were included for analysis, including 196 individuals reported non-COVID-19 infection and 1379 individuals reported recovery from COVID-19 for more than 4 weeks. With regard to sexual health, the PEDT scores of infected males were significantly higher than those of uninfected males (6.32±3.98 vs. 5.03±4.19, P=0.004), while IIEF-5 scores and prevalence of erectile dysfunction (ED) were not significantly different between infected and uninfected male groups via univariate analysis. Also, no significant differences were found between infected and uninfected female groups regarding the FSFI scores and prevalence of female sexual dysfunction (FSD). Furthermore, the logistic regression analysis showed that there was no significant correlation between COVID-19 infection experience and the occurrence of ED/FSD. In addition, more than half of male and female respondents who have contracted COVID-19 reported that their sexual desire, sexual intercourse frequency, satisfaction, and masturbation frequency were not lower than those before COVID-19 infection. With respect to reproductive health, 56.65% of male and 61.20% of female respondents planned to delay pregnancy, and the main reasons were worried about the health of offspring and increased risks of women's health due to previous COVID-19 infection.

CONCLUSIONS

Our results show that males with COVID-19 infection experience had higher PEDT scores, while there was no significant correlation between COVID-19 infection experience and the occurrence of ED/FSD among Chinese population. Whether previous COVID-19 infection experience affects fertility has become a growing concern, and further follow-up is needed to investigate long-term effects of COVID-19 infection experience on reproductive health.