Is Sexual Route a Matter of Concern for the SARS-CoV-2/COVID-19?

Patel, Shailesh Kumar; Pathak, Mamta; Sah, Ranjit; Kumar, Akshay; Malik, Yashpal Singh; Rodríguez‐Morales, Alfonso J.; Dhama, Kuldeep

doi:10.1016/j.arcmed.2020.06.008

Cited by 3 publications

(5 citation statements)

References 14 publications

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“…Concerning the detection of SARS-CoV-2 mRNA in seminal fluid, literature searches are still controversial and therefore inconclusive [ 82 ]. Most of the studies, including our meta-analysis, have not confirmed the existence of the SARS-CoV-2 virus in the semen of male COVID-19 patients, while some studies have detected the virus RNA in the semen of COVID-19-infected patients [ 83 – 85 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on testicular function: a systematic review and meta-analysis

Cannarella,

Marino,

Crafa

et al. 2024

Endocrine

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Introduction Studies investigating the effects of SARS-CoV-2 on male reproductive function are few and heterogeneous, and results are often conflicting. This systematic review and meta-analysis was carried out on studies conducted in men with active or anamnestic SARS-CoV-2 infection to evaluate its consequences on the male sex hormone profile and semen parameters. Materials and method This meta-analysis follows the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. PubMed, Scopus, Cochrane, and Embase databases were searched to identify relevant studies. We originally selected 3553 articles. After the eligibility phase, 16 articles met our inclusion criteria encompassing 11 case-control studies and 5 cohort studies (2 prospective and 3 retrospective studies). We performed the quantitative analysis with Comprehensive Meta-Analysis Software. Cochran-Q and heterogeneity (I2) indexes were used to assess statistical heterogeneity. Sensitivity analysis and publication bias tests were also performed. Results Overall, 1250 patients with active or recent (up to 80 days before) COVID-19 infection and 1232 matched healthy controls were included. Sperm concentration, total sperm count, and total motility were significantly lower in patients compared with controls. Patients also showed lower levels of total testosterone and follicle-stimulating hormone, and higher levels of luteinizing hormone, 17β-estradiol, and prolactin compared with healthy controls. None of the included studies found the presence of SARS-CoV-2 mRNA in the semen of infected patients. Conclusion The present systematic review and meta-analysis suggests the presence of an association between SARS-CoV-2 infection and primary testicular damage manifested with a picture of altered steroidogenesis and worsening spermatogenesis. The absence of the virus in the seminal fluid indicates a low possibility of sexual transmission of the infection to partners and offspring. However, our findings mostly show short-term follow-up, while few studies have considered the long-term consequences of the viral infection, thus further studies are needed to evaluate the long-term consequences on male reproductive health.

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Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on testicular function: a systematic review and meta-analysis

Cannarella,

Marino,

Crafa

et al. 2024

Endocrine

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“…(3) Respiratory and gastrointestinal symptoms of the disease were the first to be described (3) but some authors reported testicular discomfort in cases of acute infection. (2) Aerosols and contact are the main transmission routes of this virus; (4) however, SARS-CoV-2 has been found to be present in semen samples from COVID-19-positive patients and those in recovery. (5) The testes possess a privileged immune system that protects immunogenic germ cells from the host's systemic response.…”

Section: Dear Editormentioning

confidence: 99%

“…(2,5) If viral replication does not occur, this pathogen could persist due to the specialized testicular immune defense system. (5) Damage to this immune environment can lead to orchitis, testicular injuries, and male fertility impairment (4) because of widespread destruction of germ cells and sperm, secondary to leukocyte infiltration. (1) Coronavirus infection (SARS-CoV), which shares similarities with SARS-CoV-2, has been reported as a cause of orchitis (1) and both use the angiotensin-converting enzyme 2 (ACE2) as the receptor for invading cells.…”

Section: Dear Editormentioning

confidence: 99%

“…(1) Coronavirus infection (SARS-CoV), which shares similarities with SARS-CoV-2, has been reported as a cause of orchitis (1) and both use the angiotensin-converting enzyme 2 (ACE2) as the receptor for invading cells. (4) Furthermore, spermatogonia, Leydig cells, and Sertoli cells are known to be ACE2-positive cells. (4) The testes, and especially ACE2-positive cells, should be considered susceptible to SARS-CoV-2 infection and the binding of this virus to its receptor can alter tissues and thus be a source of viral transmission.…”

Section: Dear Editormentioning

confidence: 99%

“…(4) Furthermore, spermatogonia, Leydig cells, and Sertoli cells are known to be ACE2-positive cells. (4) The testes, and especially ACE2-positive cells, should be considered susceptible to SARS-CoV-2 infection and the binding of this virus to its receptor can alter tissues and thus be a source of viral transmission.…”

Section: Dear Editormentioning

confidence: 99%

See 2 more Smart Citations

Prevention of sexual transmission of SARS-CoV-2: condom or abstinence?

2021

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In December 2019, in the province of Hubei (Wuhan-China), there was an outbreak of a coronavirus-associated pneumonia, called coronavirus disease 2019 (COVID 19).(1) SARS-CoV-2 enters the cell by angiotensin-converting enzyme 2 (ECA 2) receptors that are expressed in multiple organs, including testicular tissue.(2) Protein S is most likely primed by transmembrane serine protease 2 (TMPRSS2), which interacts with ACE receptors, resulting in the successful entry of the virus into the cell.

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