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Рискове и предизвикателства пред защитата на данните в ерата на COVID - 19
Златогор Минчев
The rapid spread of COVID-19 among the human population and the occurrence of complications of the disease, including sexual function, lead to the relevance of researches among the medical and scientific community. The results of epidemiological studies indicate that COVID-19 more often affects men than women. Also, among the significant factors for the development of complications are the age and presence of comorbidities, among which diabetes, hypertension and obesity play an important role. Erectile dysfunction (ED) in men today is considered as a marker of endothelial dysfunction and systemic inflammation caused by the background disease, and the presence of comorbidities. Modern views on the pathogenesis of the development of ED in men who had COVID-19, and the features of development of sexual function in the presence of comorbidities are presented in the article. According to modern positions, one of the main mechanisms of penetration of the SARS-CoV-2 virus is its interaction with angiotensin-converting enzyme 2 and transmembrane serine protease 2. Immunohistochemical studies have established a high expression of these enzymes in the endothelial cells of testicular tissue in men, which is currently considered by researchers as a direct damaging factor for the normal functioning of Leydig and Sertoli cells. Subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics cause the potential development of ED. Also, in the pathogenesis of ED development in men who have been ill with COVID-19, important attention is paid to the role of systemic inflammation caused by the disbalance of proinflammatory and anti-inflammatory cytokines. The relevant problem of today is the influence of coronavirus on the reproductive function of men. It is known that now male infertility has been diagnosed more often than before. In addition, there are enough reasonable factors to expect the effects of the negative effects of the COVID-19 not only on reproductive health but also on sexual and cardiovascular health of men, both in the short-term and in the long-term perspective.
COVID-19在人群中的快速传播以及该疾病并发症(包括性功能)的发生,导致医学界和科学界的研究具有相关性。流行病学研究结果表明,COVID-19更常影响男性而非女性。此外,年龄和合并症的存在是并发症发生的重要因素,其中糖尿病、高血压和肥胖起着重要作用。如今,男性勃起功能障碍(ED)被认为是由背景疾病引起的内皮功能障碍和全身性炎症的标志,并存在合并症。本文介绍了COVID-19男性ED发病机制的现代观点,以及存在合并症时性功能发展的特点。根据现代观点,SARS-CoV-2病毒渗透的主要机制之一是与血管紧张素转换酶2和跨膜丝氨酸蛋白酶2的相互作用。免疫组织化学研究已经证实,这些酶在男性睾丸组织内皮细胞中有高表达,目前研究人员认为这是睾丸间质和支持细胞正常功能的直接损害因素。亚临床性腺功能减退、心理困扰和肺血流动力学受损可导致ED的潜在发展。此外,在COVID-19男性患者ED的发病机制中,促炎和抗炎细胞因子失衡引起的全身性炎症的作用受到了重要关注。今天的相关问题是冠状病毒对男性生殖功能的影响。众所周知,现在男性不育症的诊断比以前更多。此外,有足够的合理因素可以预期,2019冠状病毒病不仅会对生殖健康产生负面影响,而且会对男性的性健康和心血管健康产生短期和长期影响。
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Ролята на ГИМ/ ГМИС и предизвикателствата на COVID пандемията
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