Impact of the SARS‐CoV‐2 virus on male reproductive health

Abstract

The coronavirus 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to more than 160 million infections and 3.5 million deaths globally. Men are disproportionately affected by COVID-19, having more severe disease with higher mortality rates than women. Androgens have been implicated as the underlying cause for more severe disease, as the androgen receptor has been noted to upregulate the cell surface receptors that mediate viral cell entry and infection. Unfortunately, despite testosterone's potential role in COVID-19 prognosis, androgen deprivation therapy is neither protective nor a treatment for COVID-19. Interestingly, the male reproductive organs have been found to be vulnerable in moderate to severe illness, leading to reports of erectile dysfunction and orchitis. COVID-19 viral particles have been identified in penile and testis tissue, both in live patients who recovered from COVID-19 and post mortem in men who succumbed to the disease. Although sexual transmission remains unlikely in recovered men, moderate to severe COVID-19 infection can lead to germ cell and Leydig cell depletion, leading to decreased spermatogenesis and male hypogonadism. The objective of this review is to describe the impact of SARS-CoV-2 on male reproductive health. There are still many unanswered questions as to the specific underlying mechanisms by which COVID-19 impacts male reproductive organs and the long-term sequelae of SARS-CoV-2 on male reproductive health.

long-term impact of COVID-19 infection on semen quality of the COVID-19 survivors

“…Direct SARS-CoV-2 infection of Leydig cells may lead to testicular hypofunction, especially in severe diseases. 31 In a postmortem examination of the testes from 12 COVID-19 patients conducted by Yang M, et al, the mean number of Leydig cells per tubule cross-section in COVID-19 testes was significantly lower compared with 5 non-COVID-19 patients' testes (2,2 vs. 7,8; p<0,001). In addition, only 3 out of 12 COVID-19 patients' testes showed normal signs of spermatogenesis.…”

High-Throughput Screening of FDA-Approved Drug Library Reveals Ixazomib Is a Broad-Spectrum Antiviral Agent against Arboviruses

“…Six main targets were classified: receptor tyrosine kinase (RTK), 20S proteasome β5, ion channel, DNA synthesis, antibacteria or protozoa drugs and natural products ( Figure 1 b). Numerous studies report RTK inhibitors, ion channel inhibitors, DNA synthesis inhibitors, antibacteria or protozoa drugs and natural products to be arbovirus antivirals [ 14 , 15 , 16 , 17 ]. However, little work has been conducted regarding 20S proteasome β5 inhibitors as direct-acting antivirals.…”

A factor not to be ignored in post‐COVID ‐19 erectile dysfunction; psychological effect, a prospective study

“…Every day, a new study reveals the widespread effects of COVID‐19 on different organs throughout the body. Erectile dysfunction has also been shown to be one of these effects (Kaynar et al, 2022 ; Nassau et al, 2021 ). It has been suggested that the underlying pathophysiological mechanism of ED is endothelial damage.…”