SARS-CoV-2: the endocrinological protective clinical model derived from patients with prostate cancer

Vignera, Sandro La; Cannarella, Rossella; Condorelli, Rosita A.; Torre, Francesco; Aversa, Antônio; Calogero, Aldo E.

doi:10.1177/2042018820942385

Cited by 9 publications

(16 citation statements)

References 5 publications

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“…Nor do we find evidence that low T offers protection against COVID-19 infection or adverse outcome, as proposed by some. 2,10,11 On the contrary, the limited available data suggest low T is a risk factor, or perhaps a predictor, of severe disease with COVID-19 in men. Most men die of COVID-19 when they are elderly and serum T is extremely low.…”

Section: Study Limitationsmentioning

confidence: 99%

“…37 Numerous publications have argued that the greater impact of COVID-19 on men is explained by androgenic upregulation of ACE2 and TMPRSS2. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Recently it was reported that men are consistently overrepresented in COVID-19 mortality and this is attributed, in part, to gender-specific behaviors, genetic and hormonal factors, and sex differences in biological pathways related COVID-19 infection. 38 In addition, social, behavioral and comorbidity factors are implicated in the generally worse outcomes in men as compared with women.…”

Section: Deaths In Different States Within the United Statesmentioning

confidence: 99%

“…This is contrary to the postulated role of T in increased infection and death in men by COVID-19. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] In fact, in a recent study in which 32 men who were diagnosed with COVID-19 and were receiving T therapy were propensity score matched to 63 men diagnosed with COVID-19 but were not receiving T therapy. 84 T therapy was not associated with a worse clinical outcome in men diagnosed with COVID-19.…”

Section: Study Limitationsmentioning

confidence: 99%

“…This led to speculation that intrinsic biological differences between men and women, such as testosterone (T), may be responsible for the higher disease burden in men. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] This speculation is widespread, as a MEDLINE search already reveals publication of an astonishing 71 articles through September 7, 2020 using key words ''androgens'' and ''COVID-19.'' Biological plausibility has been claimed based on reports that androgens upregulate expression of the two key proteins involved in viral entry into host cells, namely angiotensin converting enzyme 2 (ACE2) and the transmembrane protease serine 2 (TMPRSS2).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

What’s Testosterone Got to Do with It? A Critical Assessment of the Contribution of Testosterone to Gender Disparities in COVID-19 Infections and Deaths

Traish

Morgentaler

2021

Androgens: Clinical Research and Therapeutics

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Section: Study Limitationsmentioning

confidence: 99%

Section: Deaths In Different States Within the United Statesmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

What’s Testosterone Got to Do with It? A Critical Assessment of the Contribution of Testosterone to Gender Disparities in COVID-19 Infections and Deaths

Traish

Morgentaler

2021

Androgens: Clinical Research and Therapeutics

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“…According to La Vignera et al, androgens sustain the expression of ACE2; this fact may explain the reasons why men are more exposed to the virus. In fact, prostate cancer patients undergoing Androgen Deprivation Therapy (ADT) show a lower expression of ACE2; therefore, ADT could deter SARS-CoV-2 penetration ( La Vignera et al, 2020 ). Eventually, available literature suggests that androgens lead to the generation of an overexpression of TMPRSS2 too, which is crucial for the virus to be able to infect ( Lamy et al, 2020 ; La Vignera et al, 2020 ).…”

Section: Gender Differences In Patients With Covid-19: Why Do Men Appmentioning

confidence: 99%

Coronavirus Disease-19 Infection: Implications on Male Fertility and Reproduction

et al. 2020

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The pandemic caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has led to several concerns on male fertility. Nowadays, there are numerous unanswered questions, for example: is the virus present or not in the seminal fluid of infected subjects? Could the seminal fluid represent a way of sexual transmission for the virus? Why do men appear to be more susceptible than women? Several studies have been carried out to ascertain the presence of SARS−CoV−2 in the seminal fluid, with contrasting results; the expression of angiotensin-converting enzyme-2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in the testes and in the male genital tract led to speculation about the possible presence of the virus in the seminal fluid. However, it was found that ACE2 and TMPRSS2, used by the virus to enter host cells, are expressed differently in certain testicle cells (stem germ cells, Leydig and Sertoli cells), yet the testicle cells in which ACE2 and TMPRSS2 molecules are simultaneously expressed are rare. This fact would suggest that the virus is not able to enter testicular cells, that it is not present in the seminal fluid and that it cannot infect male germ cells. However, the direct influence of SARS-CoV-2 on the testes is still to be evaluated, and recent results are very controversial. SARS-CoV-2 could enter the testicle using alternative paths and lead to alterations in testicular functionality. Another plausible consideration is that the COVID-19 disease could also indirectly cause alterations to testicular activity, since the fever and the cytokinic storm generated by the immune system can lead to damage of the testicular activity, consequently compromising male fertility. Although the literature provides controversial evidence, the purpose of this review is to lend a general overview about the state of the art. Despite the lack of studies, it would represent a starting point for further investigation about the effect of this coronavirus on male fertility.

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

et al. 2021

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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...

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SARS-CoV-2: the endocrinological protective clinical model derived from patients with prostate cancer

Cited by 9 publications

References 5 publications

What’s Testosterone Got to Do with It? A Critical Assessment of the Contribution of Testosterone to Gender Disparities in COVID-19 Infections and Deaths

What’s Testosterone Got to Do with It? A Critical Assessment of the Contribution of Testosterone to Gender Disparities in COVID-19 Infections and Deaths

Coronavirus Disease-19 Infection: Implications on Male Fertility and Reproduction

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

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