Management of Persistent Erectile Dysfunction after COVID-19 Infection: An 18-Month Follow-Up Case Report
, Giuseppe Seminara 1,2, Maria Carmela Zagari 1,2, Luigi Di Luigi 3 and Antonio Aversa 1,2,*Round 1
Reviewer 1 Report
The document of Stefano Iuliano et al. to be rejected:
Although the topic might be interesting a single case is not enough to support a possible relationship between COVID-19 infection and erectile dysfunction. Furthermore, even for the hypothesis of therapy with vitamin D supplement to treat such a pathology should be supported by a greater number of cases.
Author Response
The document of Stefano Iuliano et al. to be rejected:
Although the topic might be interesting a single case is not enough to support a possible relationship between COVID-19 infection and erectile dysfunction. Furthermore, even for the hypothesis of therapy with vitamin D supplement to treat such a pathology should be supported by a greater number of cases.
Response 1: We thank the reviewer for his/her suggestion. We agree with the reviewer comment, therefore we reported the single case as well as the therapy with vitamin D as a limitation in the conclusion section (page 7, line 415). Recent data from a greater number of cases may support the possible relationship between COVID-19 and erectile dysfunction (Zhang et al., 2022).
Author Response File: 
Author Response.docx
Reviewer 2 Report
Minor corrections:
Page 1 line 40: Data from recent studies suggest a statistical association of COVID-19 with ED---include more sources.
There are quite a number of abbreviations that needs to be defined e.g. ARD, TMPRSS2, VD.
Page 3, line 130-131...not sure what the authors are passing across. Please check this.
The authors need to clarify the timepoints for which the penile duplex ultrasound was performed in text.
Major:
The mechanism(s) of the development of ED in relation to Covid-19 is not logically presented in the introduction. This section needs to be clearly written.
A schematic may be included to describe pathway in which covid-19 results in ED.
The results should be written separately from the patient and methods for clarity.
Author Response
Minor corrections:
Page 1 line 40: Data from recent studies suggest a statistical association of COVID-19 with ED---include more sources.
Response 1: As proposed by the reviewer 2, we added more sources to the sentence (page 2, line 48).
There are quite a number of abbreviations that needs to be defined e.g. ARD, TMPRSS2, VD.
Response 2: As suggested by the reviewer, we clarified abbreviations throughout the manuscript.
Page 3, line 130-131...not sure what the authors are passing across. Please check this.
We thank the reviewer for his/her suggestion. For mere mistake we repeated “success rate”. So we reformulated the sentence (page 3, lines 260, 261).
The authors need to clarify the timepoints for which the penile duplex ultrasound was performed in text.
Response 3: As suggested by the reviewer, we specified the timepoints which the penile duplex ultrasound was performed (page 3, lines 263, 2264 and page 4, line 301, figure 2 and figure 3).
Major:
The mechanism(s) of the development of ED in relation to Covid-19 is not logically presented in the introduction. This section needs to be clearly written.
Response 4: We thank the reviewer for his/her suggestion. To better clarify this aspect, we updated the paragraph.
A schematic may be included to describe pathway in which covid-19 results in ED.
Response 5: As suggested by the reviewer we added a figure to better summarize the pathways by which covid-19 could results in ED (page 3, figure 1).
The results should be written separately from the patient and methods for clarity.
Response 6: We thank the reviewer for his/her suggestion. We decide to separate the results from the patient and methods creating the third paragraph (Results).
Author Response File: Author Response.docx
Reviewer 3 Report
1. Abbreviation of VD and LI-SWT need to incorporated in the text.
2. Line no 131- sexual success rate - is repeated .
3. Line 119- FANS-?
4. Line no . 211- PCR need to replace with CRP.
5. Conclusion need to make more short and precise based on your observation of the reported case
Author Response
- Abbreviation of VD and LI-SWT need to incorporated in the text.
Response 1: As mentioned above, we clarified abbreviations throughout the manuscript.
- Line no 131- sexual success rate - is repeated .
Response 2: We thank the reviewer for his/her suggestion. For mere mistake we repeated “success rate”. So we reformulated the sentence (page 3, lines 260, 261).
- Line 119- FANS-?
Response 3: As highlighted by the reviewer, we updated the terminology.
- Line no . 211- PCR need to replace with CRP.
Response 4: As suggested by the reviewer, we updated the terminology throughout the text.
- Conclusion need to make more short and precise based on your observation of the reported case OK
Response 5: We thank the reviewer for his/her suggestion and so we updated the manuscript accordingly.
Author Response File: Author Response.docx
Reviewer 4 Report
The authors reported a report on a case of a 35-year-old married male admitted in July 2021 because of sudden onset erectile dysfunction (ED) with 18 months of follow-up. The case is interesting and could be considered after a major revision.
- Please make the introduction more incisive. Please eliminate repetitions and too detailed descriptions. Those should be included in the discussion section.
- Sexual function is often impaired in patients with chronic illnesses. This should be taken into account when considering DE. Moreover, several patients with chronic gastrointestinal have been shown to suffer from sexual dysfunction. Please include this consideration in your paper (DOI: 10.1111/andr.13186; PMID: 35419983).
- Please make the conclusion shorter in order to make them more vigorous.
- The COVID-19 pandemic has caused wide-reaching change to many aspects of life on a worldwide scale. In this view, please include this interesting paper (DOI: 10.5173/ceju.2021.291; PMID: 35591965).
- Check typos
Author Response
The authors reported a report on a case of a 35-year-old married male admitted in July 2021 because of sudden onset erectile dysfunction (ED) with 18 months of follow-up. The case is interesting and could be considered after a major revision.
We thank the reviewer for this important comment.
- Please make the introduction more incisive. Please eliminate repetitions and too detailed descriptions. Those should be included in the discussion section.
Response 1: We thank the reviewer for his/her suggestion. To ameliorate the text, we eliminated repetitions and some sentences.
- Sexual function is often impaired in patients with chronic illnesses. This should be taken into account when considering DE. Moreover, several patients with chronic gastrointestinal have been shown to suffer from sexual dysfunction. Please include this consideration in your paper (DOI: 10.1111/andr.13186; PMID: 35419983).
Response 2: As suggested by the reviewer we reported the possible relationship between chronic disease and erectile dysfunction (page 2, lines 80, 81).
- Please make the conclusion shorter in order to make them more vigorous.
Response 3: As suggested by the reviewer, we updated the manuscript.
- The COVID-19 pandemic has caused wide-reaching change to many aspects of life on a worldwide scale. In this view, please include this interesting paper (DOI: 10.5173/ceju.2021.291; PMID: 35591965).
Response 4: As proposed by the reviewer we reported the relationship between psychological discomfort and pandemic (page 2, line 47).
- Check typos
Response 5: As suggested by the reviewer we ameliorated the manuscript.
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
Since the authors have made my suggestions, the paper can be accepted in present format.
Reviewer 4 Report
the manuscript is worthy of publication after this round and the authors should be congratulated for the revised version.
