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

Abstract

Background: As of March 11, 2020, the COVID-19 outbreak was declared as a pandemic. Expending our understanding of the transmission routes of the viral infection is crucial in controlling the outbreak. It is unclear whether the 2019 novel coronavirus (2019-nCoV) can directly infect the testes or male genital tract and be sexually transmitted from males. Methods: From January 31 to March 14, 2020, 12 patients in recovery and one patient died of COVID-19 were included in this descriptive study. The clinical characteristics, laboratory findings, chest CT scans and outcome data were recorded. To examine whether there is sexual transmission from male, we employed realtime polymerase chain reaction testing (RT-PCR) to detect 2019-nCov in semen or testicular biopsy specimen. Findings: The age range of the 12 patients in recovery was 22-38 years. None of the patients developed severe COVID-19 pneumonia. As of March 14, 2020, ten patients discharged from the hospital while the rest 2 had developed into recovery stage. All of the patients in recovery tested negative for 2019-nCoV RNA in semen samples. Another died patient was 67 years old, who died in March 10, 2020 and tissue sample via testicular biopsy was tested negative for viral RNA. Conclusion: No positive RT-PCR result was found in the semen or testicular biopsy specimen. The results from this study show no evidence of sexual transmission of 2019-nCov from males.

COVID-19 and the male susceptibility: the role of ACE2, TMPRSS2 and the androgen receptor

“…ACE2 is not only found in the lungs resulting in respiratory symptoms and lung injury of the SARS-CoV2, but also in many other organs including kidneys, prostate and intestines, suggesting other possible routes of viral transmission, and testes, hence possibly requiring a long-term follow-up of the reproductive function in males. While some authors reported the absence of SARS-CoV2 in the semen of males recovering from COVID-19 [5], others have shown its presence in the semen of active and recovering patients. [6].…”

Could COVID‐19 have an impact on male fertility?

“…In a recent study, Song et al (2020) collected 12 semen samples from survived COVID‐19 patients and testicular biopsies from a dead COVID‐19 patient. In the semen samples and in testicular biopsy, tissues were not detected 2019‐nCov RNA.…”

Extrapulmonary Clinical Manifestations in COVID-19 Patients

“…18 A study on 12 COVID-19 patients demonstrated the absence of viral RNA in testicular biopsy tissues. 103 It indicates that SARS-CoV-2 cannot directly infect testes or the male genital tract even in the acute phase; therefore, no evidence shows that the novel coronavirus can be sexually transmitted from males. 103 Other studies indicated that serum LH in males with COVID-19 infection could be significantly increased; however, the ratio of T to LH and the ratio of follicle-stimulating hormone (FSH) to LH are dramatically decreased.…”