Clinical features and sexual transmission potential of SARS-CoV-2 infected female patients: a descriptive study in Wuhan, China

Abstract

Background: As of March 2, 2020, SARS-CoV-2 has infected more than 80174 people and caused 2915 deaths in China. This virus rapidly spreads to 56 countries worldwide. Thus, in order to effectively block its transmission, it is urgent to uncover all the possible transmission routes of SARS-CoV-2. Methods: From January 28 to February 18, 2020, 35 female patients diagnosed with COVID-19 in Tongji Hospital were included in this descriptive study. The gynecologic history, clinical characteristics, laboratory findings and chest computed tomography (CT) of all patients were recorded in detail. To examine whether there is sexual transmission through vaginal from female to her partner, we employed realtime polymerase chain reaction testing (RT-PCR) to detect SARS-CoV-2 in vaginal environment (including vaginal discharge, cervical or vaginal residual exfoliated cells) and anal swab samples, and inquired recent sexual behaviors from the patients. Findings: The age range of the 35 patients with COVID-19 was 37-88 years. Over 50% patients infected with SARS-CoV-2 had chronic diseases. We tested the vaginal environment and anal swabs from the 35 female patients with COVID-19 and found that only an anal swab sample from one patient was positive for SARS-CoV-2. All the samples from vaginal environment were negative for SARS-CoV-2. The infection rate of the patients' sexual partner was 42·9%. Additionally, two female patients admitted having sex with their partners during a possible infection incubation period, while one patient's partner was uninfected and the other patient's partner was diagnosed with COVID-19 (after the diagnosis of the female patient). Conclusion: No positive RT-PCR result was found in the vaginal environment perhaps due to the lack of ACE2 expression, which is the receptor of SARS-CoV-2, in the vagina and cervix tissues (human protein atlas). The results from this study show no evidence of transmission of SARS-CoV-2 through vaginal sex from female to her partner. However, the risk of infection of non vaginal sex and other intimate contacts during vaginal sex should not be ignored.

A single-cell RNA expression map of human coronavirus entry factors

“…We conclude that a subset of trophoblast cells may be permissive to SARS-CoV-2 entry. Overall, our findings for the placenta are consistent with current clinical data suggesting that vertical transmission of SARS-CoV-2 from infected mother to fetus is plausible, but probably rare (Baud et al, 2020;Chen et al, 2020a;Cui et al, 2020;Hosier et al, 2020;Zeng et al, 2020). Future studies should be directed at examining SCARF expression at different .…”

Absence of 2019 novel coronavirus in semen and testes of COVID-19 patients†

“…Among COVID-19 patients, there are more men than women [1]. Although recent reports found no evidence of either sexual or vertical transmission by women infected with the 2019-nCoV [4,5], very little is known about the potential impact of 2019-nCoV infection on the male reproductive system. Of interest, bioinformatic analyses have revealed that angiotensin-converting enzyme 2, a receptor utilized by the 2019-nCoV, is abundantly expressed in the testis and male reproductive tract [6,7], raising an urgent question of potential sexual transmission through semen by men.…”

Detection of 2019 novel coronavirus in semen and testicular biopsy specimen of COVID-19 patients

“…Recently, two studies have answered whether 2019-nCoV could spread sexually or vertically and pose risks to the fetus and neonate among female patients [7,8]. No evidence was showed for sexual transmission or intrauterine infection caused by vertical transmission in women who develop COVID-19 pneumonia.…”