Coronavirus and Sexual Transmission: A Systematic Review

Abstract

Introduction: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS) was first identified in December 2019 in Wuhan, China. Although the respiratory system is infected in this disease, other tissues are prone to coronavirus attack so that the male reproductive system is another target for the virus causing sexual transmission of coronavirus. This study systematically examined the results of studies conducted on COVID-19 and possible sexual transmission of this virus. Method: This was a systematic review study in which the articles and papers were collected by using some keywords such as COVID-19, Semen, Novel Coronavirus, SARS-COV-2, ACE2, and Male Infertility searching through databases (PubMed, Web of Science, Scopus, Google Scholar) using OR and AND operators from December 2019 to November 2020. Finally, 13 papers as eligible articles were studied. Findings: The collected papers were reviewed, and ultimately 13 papers were entered into this study. According to current studies, the Angiotensin-converting enzyme (ACE2), which is found abundantly in testicles can perform as a cellular receptor for SARS-COV-2. This finding is the foundation of this hypothesis that human testis and semen can be infected by SARS-COV-2. In particular, a study showed that SARS-COV-2 might be detected in semen of patients with COVID-19 while other studies found no viral RNA in testicular biopsy tissue. Furthermore, some studies concluded that this virus, even in the acute phase, could not infect testicles or the male genital system. Accordingly, no evidence confirms that this virus can be transmitted through male genital organs. Conclusion: Although this virus has not been detected in semen fluid and it has not been sexually transmitted, one study found this virus in semen of coronavirus-infected patients and introduced its possible sexual transmission. Therefore, there is a low probability of sexual transmission of coronavirus.