Hemorrhagic testicular infarction as a complication of COVID-19 (SARS-COV-2). Clinical case

Introduction. Statistically, adult patients with testicular infarction make up 7-10% of the population of all acute urological pathology. This is one of the urological nosologies, which is a part of a group of diseases called «acute scrotum». Ischemic heart attack occurs as a result of an acute violation of the blood supply to the testicle from the testicular artery. Hemorrhagic infarction usually occurs as a result of impaired microcirculation or embolization of the arteries and arterioles of the testicle and is most often segmental in nature. Conditions associated with increased blood clotting also create conditions for vein obstruction with subsequent tissue necrosis in any organ, including in the testicles. It is known that COVID-19 (SARS-COV-2) causes a pathological increase in blood clotting in the patient's body and it's most dangerous complication is thrombosis in various blood vessels of the patient's organs, which often causes acute ischemia of these organs and even death in patients with COVID 19. Materials and methods. The authors consider 3 similar clinical observations of hemorrhagic testicular infarction in patients suffering from COVID-19 (SARS-COV-2) and who were in the specialized COVID department of the city hospital of Pyatigorsk (Russia, Stavropol Territory). All 3 patients were aged from 67 to 88 years and had a concomitant pathology from the cardiovascular system in the form of arterial hypertension, as well as type 2 diabetes mellitus. The authors provide one case in detail, since all 3 cases followed the same clinical scenario. Clinical observation: Patient B. 66years old, who was in a specialized COVID department with a diagnosis of: Coronovirus infection caused by COVID 19 (confirmed), moderate form of UO7.1, community-acquired bilateral lobar pneumonia, acute respiratory distress syndrome, respiratoryfailure. Concomitant diseases: atherosclerotic cardiosclerosis, arterial hypertension, type 2 diabetes mellitus. The patient received therapy for the underlying disease, but on the 9th day of his stay in the hospital, he had an acute hemorrhagic infarction of the left testicle. The diagnosis was confirmed by laboratory and instrumental examination. An emergency left-sided orchectomy was performed, and the diagnosis was confirmed histologically. Similar clinical situations were observed in two other patients with the same outcome. Conclusions. Hemorrhagic testicular infarction in patients with COVID-19 in our clinical observation can be considered as a complication of COVID-19, or as its clinical manifestation in the organs of the male reproductive system.