A review of severe acute respiratory syndrome coronavirus 2 infection in the reproductive system

Kumari

Middle East Fertil Soc J

et al. 2021

Background COVID-19 is the most recent zoonotic outbreak of coronaviruses. Mostly, it invades the cells of the respiratory system by binding to the receptor angiotensin-converting enzyme 2 (ACE2) which is also present in other organs like the kidney, testis, ovaries, breast, heart, and intestine, rendering them prone to be infected. The reproductive potential is a must for the sustenance of any species and it is our prime duty to safeguard the reproductive system of the present generation from such a deadly virus. The previously reported coronaviruses like severe acute respiratory syndrome coronavirus (SARS-CoV) had a detrimental impact on reproductive organs. There is a dearth of sufficient research to provide substantial evidence for the harmful effects of this novel virus on the reproductive system. Hence, our review compiles the knowledge available until now to boost research in this regard and to take the necessary steps in time. Main body of abstract Here we tried to compile all the data available on the effect of SARS-CoV-2 on the reproductive system as well as vertical transmission of the virus. All related articles published from February to August 2020 were reviewed and thoroughly analyzed. SARS-CoV-2 has been found to affect the sperm concentration and motility, thus degrading the fertility of males. In females, it is suspected that this virus affects the oocyte quality and ovarian function, resulting in infertility or miscarriage. Traces of SARS-CoV-2 virus have also been found in the breast milk of the infected mothers and the semen of infected males. Vertical transmission of SARS-CoV-2 has also been reported in some cases. Conclusion Based on the literature review, SARS-CoV-2 seems to have the potential of affecting both male and female reproductive tracts. This review brings together the findings and observations made in the area of reproductive health during the current pandemic. The reproductive system of the young population is preordained for subsequent disorders, infertility, reduced sperm count, and motility. Therefore, the research and medical practices should focus on possible vulnerability being posed by SARS-CoV-2 to the gametes and future generations. We, hereby, recommend close monitoring of young and pregnant COVID-19 patients concerning reproductive health with utmost priority.

Section: Sars-cov-2 and Male Reproductive Systemmentioning

confidence: 99%

SARS-CoV-2 and the reproductive system: known and the unknown..!!

Kumari

Middle East Fertil Soc J

et al. 2021

“…Post‐mortem examinations of testicular tissue from 12 COVID‐19 patients showed significantly reduced Leydig cells, as well as oedema and inflammation in the interstitium 21 . Whether SARS‐CoV‐2 virus can be found in semen is still debated 22,23 …”

Section: Discussionmentioning

confidence: 99%

Male pituitary–gonadal axis dysfunction in post‐acute COVID‐19 syndrome—Prevalence and associated factors: A Mediterranean case series

Moreno-Pérez

Merino

Alfayate

et al. 2021

Clinical Endocrinology

Objective Severe acute respiratory syndrome coronavirus 2 through angiotensin‐converting enzyme 2 receptor can harm testes function. The objectives were to analyse the prevalence of low serum testosterone (LT) and impaired fertility potential (Leydig and Sertoli cells dysfunction, respectively) in coronavirus disease 2019 (COVID‐19) male survivors and to evaluate acute infection‐related associated factors. Also, we explore its association with post‐acute COVID‐19 syndrome (PCS) and quality of life (QOL). Materials and Methods Male adults recovered from polymerase chain reaction‐confirmed COVID‐19 were offered a structured evaluation 8–12 weeks after recovery. The main outcome measure(s) were as follows: LT, defined as total testosterone (TT) < 2 ng/ml or if TT levels 2–4 ng/ml as calculated free testosterone < 6.36 ng/dl; Sertoli cell dysfunction was defined as inhibin‐B < 89 pg/ml. Secondary outcome‐associated factors were analysed by multiple logistic regression (odds ratio; 95% confidence interval [CI]). QOL was evaluated by SF‐36 v.2. Results One hundred and forty‐three patients were evaluated at a median (interquartile range) of 77 days (72–83) after disease onset; 72% of them recovered from severe pneumonia. LT was detected in 41 patients (28.7%; 95% CI: 21.8–36.5). Low levels of inhibin‐B were detected in 25 patients (18.1%; 95% CI: 12.5–25.3). After multivariate adjustment, obesity and hypokalaemia were associated with LT, whereas age more than 65 was an independent predictor of Sertoli cell dysfunction. LT or Sertoli cell dysfunction was not associated with PCS. Patients with LT had a lower score in four domains of QOL. Conclusions Prevalence of male LT and impaired fertility potential in COVID‐19 survivors is high in the medium term. Traditional risk factors and severity markers for COVID‐19 could be predictive.

“…Female reproductive system functions, such as follicular development, steroidogenesis, oocyte maturation, ovulation, endometrial regeneration, and embryo development, are related to ACE2. ACE2 receptors are present in the breasts, endometrium, tubes, vagina, and ovary [ 35 , 44 , 45 ]. In the ovary, ACE2 receptors are expressed in the oocytes, stroma, and perivascular cells of the ovarian cortex [ 46 , 47 ].…”

Section: What Are the Issues That Might Hamper A Safe Oncofertility P...mentioning

confidence: 99%

“…The virus may affect ovarian function oocyte quality with secondary infertility or miscarriage [ 45 ]. Herrero et al have shown that SARS-CoV-2 infection can affect ovarian function and follicular microenvironment, thus affecting reproductive outcomes.…”

Section: What Are the Issues That Might Hamper A Safe Oncofertility P...mentioning

confidence: 99%

Oncofertility and COVID-19: At the Crossroads between Two Time-Sensitive Fields

Varlas

Borş

Pop

et al. 2022

JCM

Background: COVID-19 infection has dominated our lives and left its mark on it. The impact on fertility is major, and the long-term consequences may be disastrous. When we talk about oncofertility, we are talking about those patients worried about the delay in receiving medical services (possible cancelation of surgery, decreased availability of medical services, reorientation of medical resources) due to COVID-19. Finally, patients’ worsening biological and reproductive statuses, associated with high levels of anxiety and depression, are closely related to social restrictions, economic impact, reorientation of medical resources, health policies, and fears of SARS-CoV-2 infection. Aim: We reviewed the current literature on fertility during the COVID-19 pandemic and its effect on cancer patients. Specifically, how cancer treatment can affect fertility, the options to maintain fertility potential, and the recovery options available after treatment are increasingly common concerns among cancer patients. Methods: A systematic literature search was conducted using two main central databases (PubMed®/MEDLINE, and Web of Science) to identify relevant studies using keywords SARS-CoV-2, COVID-19, oncofertility, young cancer patient, cryopreservation, assisted reproductive techniques (ART), psychosocial, telemedicine. Results: In the present study, 45 papers were included, centered on the six main topics related to COVID-19. Conclusions: Fertility preservation (FP) should not be discontinued, but instead practiced with adjustments to prevent SARS-CoV-2 transmission. The increased risk of SARS-CoV-2 infection in cancer patients requires screening for COVID-19 before FP procedures, among both patients and medical staff in FP clinics, to prevent infection that would rapidly worsen the condition and lead to severe complications.