Current status of the COVID‐19 and male reproduction: A review of the literature

Abstract

Background: Coronavirus disease 2019 , which causes serious respiratory illnesses such as pneumonia and lung failure, was first reported in mid-December 2019 in China and has spread around the world. In addition to causing serious respiratory illnesses such as pneumonia and lung failure, there have been conflicting reports about the presence of SARS-CoV-2 in the semen of patients who were previously diagnosed with COVID-19 and possible implications for the male reproductive tract. Objective:The goal for the present study was to review the current status of the literature concerning COVID-19 and male reproduction. Material and methods: An electronic literature search was done by using PubMed and Google Scholar databases. Relevant papers, concerning SARS-COV-2 and COVID-19 and male reproduction, published between January 2020 and December 2020 were selected, analyzed and eventually included in the present literature review.Results: SARS-CoV-2 may infect any cell type expressing angiotensin-converting enzyme 2 (ACE2), including reproductive cells. Besides the presence of the SARS-CoV-2 receptor, the expression of host proteases, such as transmembrane serine protease 2 (TMPRSS2), is needed to cleave the viral S protein, allowing permanent fusion of the viral and host cell membranes. Here, we aimed to review the current status of the literature concerning COVID-19 and male reproduction. The lack of co-expression of ACE2 and TMPRSS2 in the testis suggests that sperm cells may not be at increased risk of viral entry and spread. However, the presence of orchitis in COVID-19-confirmed patients and compromised sex-related hormonal balance among these patients intrigues reproductive medicine.Discussion: SARS-CoV-2 may use alternate receptors to enter certain cell types, or the expression of ACE2 and TMPRSS2 may not be detected in healthy individuals. Conclusion: COVID-19 challenges all medical areas, including reproductive medicine.It is not yet clear what effects, if any, the COVID-19 pandemic will have on male reproduction. Further research is needed to understand the long-term impact of SARS-CoV-2 on male reproductive function. K E Y W O R D SCOVID-19, male reproduction, SARS-CoV-2, testicles, viral 2 | 1 | INTRODUC TI ON Since the first case of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was reported in Wuhan, China, it has rapidly spread and affected more than 21 million people worldwide as of 17 August 2020. 1 SARS-CoV-2 uses angiotensin-converting enzyme II (ACE2) to enter host cells, similar to SARS-CoV, which emerged 18 years ago. 2COVID-19 induces respiratory-predominant multiorgan dysfunction, including myocardial, renal, enteric and hepatic dysfunction, which coincides with the tissue expression of ACE2. 3 Meanwhile, several studies have shown that ACE2 is expressed in human testes (eg spermatogonia, Leydig cells and Sertoli cells), 4,5 suggesting that the testes may be another organ affected by COVID-19.Numerous viruses have been detected in human...

Andrological effects of SARS-Cov-2 infection: a systematic review and meta-analysis

“…Conversely, data on the expression of TMPRSS2 in the male genitalia tract are more conflicting [ 47 ]. The lack of co-expression of ACE2 and TMPRSS2 on sperm cells has been suggested to reduce the risk of viral direct damage [ 48 ].…”

Evaluation of SARS-CoV-2 in semen, seminal plasma, and spermatozoa pellet of COVID-19 patients in the acute stage of infection

“…The impact of SARS-CoV-2 on male reproductive function, including fertility and testicular endocrine functions, as well as its infectiousness, still remains to be determined [31,32]. Recent studies showed that COVID-19 could impair male fertility by inducing orchitis, and decreasing testosterone levels, sperm counts and motility [11,12,16,17,[33][34][35][36][37]. However, a recent review of epidemiological investigations, molecular receptor identification and detection studies of SARS-CoV-2 RNA in testicular biopsies, semen and prostatic fluids, vaginal fluids and cervical smears suggest that COVID-19 is not a sexually transmitted disease [24].…”

“…The coexpression of both ACE2 and TMPRSS2 genes was reported in spermatogonial stem cells, elongated spermatids, and in at least a small percentage of prostate hillock cells and in renal tubular cells [4][5][6][7][8][9]. The blood-testis barrier can be breached by viruses, especially in the presence of systemic and local inflammation [10][11][12]. Indeed, a wide range of viruses, such as Zika, Ebola, Influenza, Epstein Barr viruses that result in viremia can be detected in human semen [10,13].…”

Corona and Reproduction, or Why the Corona Vaccination Does Not Result in Infertility

“…The S2 subunit promotes fusion of the membranes of the virus with those of the host cell, allowing viral RNA to enter the infected cell 54 . The data on the expression of TMPRSS2 in male genitalia is still contradictory 54 . As ACE2 receptors and TMPRSS-2 are influenced by androgens, it is important to consider possible specific effects of an infection with SARS-CoV-2 on the male organism and genital tract 55 – 61 .…”

“…Untereinheit bewirkt die Fusion der Membranen von Virus und Wirtszelle und ermöglicht so den Eintritt der Virus-RNA in die infizierte Zelle[54]. Die Daten zur Expression von TMPRSS2 im männlichen Genitaltrakt sind noch widersprüchlich[54]. Da ACE2-Rezeptoren und TMPRSS-2 unter dem Einfluss von Androgenen stehen, sind mögliche spezifische Effekte einer Infektion mit SARS-CoV-2 auf den männlichen Organismus und Genitaltrakt zu beachten[55 -61].Insgesamt konnten 21 Originalarbeiten identifiziert werden, die sich mit der Frage beschäftigen, inwieweit ein SARS-CoV-2-Nachweis im Ejakulat möglich ist bzw.…”