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Majzoub A, Khalafalla K, Arafa M, El Ansari W, Nair A, Al Bishawi A, Saleh M, Khair Ella M, ElBardisi H, Khattab MA, AlRumaihi K. COVID-19 and male fertility: short- and long-term impacts of asymptomatic vs. symptomatic infection on male reproductive potential. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1403143. [PMID: 38847012 PMCID: PMC11153742 DOI: 10.3389/frph.2024.1403143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/23/2024] [Indexed: 06/09/2024] Open
Abstract
Background Studies exploring the effect of COVID-19 on male reproductive system suggest a detrimental association, however with conflicting results. The aim of this study was to assess the association between COVID-19 infection and male reproductive potential including hormone profiles and semen parameters. Methods This prospective cohort study included 48 patients with confirmed COVID-19 infection. Patients were subdivided into an asymptomatic group (n = 30) and a group with COVID-19 symptoms (n = 18). Serum hormone levels including testosterone, LH, FSH and estradiol were collected during active infection (baseline, time 0), and at 3 and 6 months following COVID-19 infection. Semen samples (basic semen analysis and oxidation reduction potential) were examined at 3 and 6 months following infection. Student and paired-t tests were used to compare continuous variables between the study groups and across the studied time intervals, respectively. Multivariate binary logistic regression analysis was performed to explore predictors for COVID-19 symptoms during active infection. Results Patients with COVID-19 symptoms were significantly older (p = 0.02) and had significantly lower serum testosterone levels (p = 0.01) and significantly higher LH: testosterone ratio (p = 0.01) than asymptomatic patients. Multivariate analysis revealed older age (OR = 1.18, p = 0.03) and lower serum testosterone level (OR = 0.8, p = 0.03) as independent predictors of symptomatic COVID-19 infection. Significant increase in testosterone (p < 0.001 for both) and decrease in LH (p = 0.02, p = 0.007) and LH: testosterone (p = 0.02, p = 0.005) levels were observed at 3 and 6 months in patients with COVID-19 symptoms. Asymptomatic patients demonstrated significant increase in testosterone (p = 0.02) and decrease in LH: testosterone (p = 0.04) levels only at 3 months following COVID-19 infection. No significant differences were observed between the two study groups with regards to the semen analysis results obtained at 3 or 6 months following COVID-19 infection. Conclusion Significantly lower testosterone values are associated with worse disease severity among men with COVID-19 infection. This association appears to be temporary as a significant increase in testosterone levels are witnessed as early as 3 months following recovery. No significant detrimental effect for COVID-19 infection on testicular sperm production is found in this patient population.
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Affiliation(s)
- Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Urology, Weill Cornell Medicine—Qatar, Doha, Qatar
| | | | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Urology, Weill Cornell Medicine—Qatar, Doha, Qatar
- Department of Andrology, Cairo University, Cairo, Egypt
| | - Walid El Ansari
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Department of Population Health, Weill Cornell Medicine—Qatar, Doha, Qatar
| | - Arun Nair
- Department of Medicine, Museaid Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Al Bishawi
- Department of Infectious Diseases, Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | - Mulham Saleh
- Department of Medicine, Um Garn Quarantine Facility, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed Khair Ella
- Department of Infectious Diseases, Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | - Haitham ElBardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Urology, Weill Cornell Medicine—Qatar, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
| | - Muhammad Abu Khattab
- Department of Infectious Diseases, Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | - Khalid AlRumaihi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Clinical Urology, Weill Cornell Medicine—Qatar, Doha, Qatar
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Zhang G, Zhi W, Ye F, Xiong D, Zhang Y, Liu F, Zhao Y, Du X, Wu Y, Hou M, Liu J, Wei J, Silang Y, Xu W, Zeng J, Chen S, Liu W. Systematic analyses of the factors influencing sperm quality in patients with SARS-CoV-2 infection. Sci Rep 2024; 14:8132. [PMID: 38584153 PMCID: PMC10999436 DOI: 10.1038/s41598-024-58797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/03/2024] [Indexed: 04/09/2024] Open
Abstract
To figure out how does SARS-CoV-2 affect sperm parameters and what influencing factors affect the recovery of sperm quality after infection? We conducted a prospective cohort study and initially included 122 men with SARS-CoV-2 infection. The longest time to track semen quality after infection is 112 days and 58 eligible patients were included in our study eventually. We subsequently exploited a linear mixed-effects model to statistically analyze their semen parameters at different time points before and after SARS-CoV-2 infection. Semen parameters were significantly reduced after SARS-CoV-2 infection, including total sperm count (211 [147; 347] to 167 [65.0; 258], P < 0.001), sperm concentration (69.0 [38.8; 97.0] to 51.0 [25.5; 71.5], P < 0.001), total sperm motility (57.5 [52.3; 65.0] to 51.0 [38.5; 56.8], P < 0.001), progressive motility (50.0 [46.2; 58.0] to 45.0 [31.5; 52.8], P < 0.001). The parameters displayed the greatest diminution within 30 days after SARS-CoV-2 infection, gradually recovered thereafter, and exhibited no significant difference after 90 days compared with prior to COVID-19 infection. In addition, the patients in the group with a low-grade fever showed a declining tendency in semen parameters, but not to a significant degree, whereas those men with a moderate or high fever produced a significant drop in the same parameters. Semen parameters were significantly reduced after SARS-CoV-2 infection, and fever severity during SARS-CoV-2 infection may constitute the main influencing factor in reducing semen parameters in patients after recovery, but the effect is reversible and the semen parameters gradually return to normal with the realization of a new spermatogenic cycle.
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Affiliation(s)
- Guohui Zhang
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study and the Center for Medical Genetics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, 610072, China
| | - Weiwei Zhi
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Fei Ye
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Dongsheng Xiong
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Yanan Zhang
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Fulin Liu
- Sichuan Provincial Key Laboratory for Human Disease Gene Study and the Center for Medical Genetics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology, Chengdu, 610072, China
| | - Yuhong Zhao
- School of Laboratory Medicine, Chengdu Medical College, Chengdu, 610500, China
| | - Xinrong Du
- Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yang Wu
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Mingxia Hou
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Jiu Liu
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Jiajing Wei
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Yangzhong Silang
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China
| | - Wenming Xu
- Department of Obstetrics and Gynecology, Joint Laboratory of Reproductive Medicine (SCU-CUHK), Key Laboratory of Obstetric, Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Jiuzhi Zeng
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China.
| | - Shiqi Chen
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China.
| | - Weixin Liu
- Key Laboratory of Reproductive Medicine, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, 610045, China.
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Hallak J, Caldini EG, Teixeira TA, Correa MCM, Duarte-Neto AN, Zambrano F, Taubert A, Hermosilla C, Drevet JR, Dolhnikoff M, Sanchez R, Saldiva PHN. Transmission electron microscopy reveals the presence of SARS-CoV-2 in human spermatozoa associated with an ETosis-like response. Andrology 2024. [PMID: 38469742 DOI: 10.1111/andr.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/05/2024] [Accepted: 01/23/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Severe acute syndrome coronavirus 2 can invade a variety of tissues, including the testis. Even though this virus is scarcely found in human semen polymerase chain reaction tests, autopsy studies confirm the viral presence in all testicular cell types, including spermatozoa and spermatids. OBJECTIVE To investigate whether the severe acute syndrome coronavirus 2 is present inside the spermatozoa of negative polymerase chain reaction-infected men up to 3 months after hospital discharge. MATERIALS AND METHODS This cross-sectional study included 13 confirmed moderate-to-severe COVID-19 patients enrolled 30-90 days after the diagnosis. Semen samples were obtained and examined with real-time polymerase chain reaction for RNA detection and by transmission electron microscopy. RESULTS In moderate-to-severe clinical scenarios, we identified the severe acute syndrome coronavirus 2 inside spermatozoa in nine of 13 patients up to 90 days after discharge from the hospital. Moreover, some DNA-based extracellular traps were reported in all studied specimens. DISCUSSION AND CONCLUSION Although severe acute syndrome coronavirus 2 was not present in the infected men's semen, it was intracellularly present in the spermatozoa till 3 months after hospital discharge. The Electron microscopy (EM) findings also suggest that spermatozoa produce nuclear DNA-based extracellular traps, probably in a cell-free DNA-dependent manner, similar to those previously described in the systemic inflammatory response to COVID-19. In moderate-to-severe cases, the blood-testes barrier grants little defence against different pathogenic viruses, including the severe acute syndrome coronavirus 2. The virus could also use the epididymis as a post-testicular route to bind and fuse to the mature spermatozoon and possibly accomplish the reverse transcription of the single-stranded viral RNA into proviral DNA. These mechanisms can elicit extracellular cell-free DNA formation. The potential implications of our findings for assisted conception must be addressed, and the evolutionary history of DNA-based extracellular traps as preserved ammunition in animals' innate defence might improve our understanding of the severe acute syndrome coronavirus 2 pathophysiology in the testis and spermatozoa.
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Affiliation(s)
- Jorge Hallak
- Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Androscience, Science & Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory., Androscience Institute, Sao Paulo, Brasil
| | - Elia G Caldini
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Thiago A Teixeira
- Androscience, Science & Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory., Androscience Institute, Sao Paulo, Brasil
- Departamento de Cirurgia, Divisão de Urologia, Hospital Universitário da Universidade Federal do Amapá, Amapá, Brazil
| | | | - Amaro N Duarte-Neto
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fabiola Zambrano
- Department of Preclinical Sciences, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Center of Translational Medicine-Scientific and Technological Bioresource Nucleus (CEMT-BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Anja Taubert
- Institute of Parasitology, Justus Liebig University Giessen, Giessen, Germany
| | - Carlos Hermosilla
- Institute of Parasitology, Justus Liebig University Giessen, Giessen, Germany
| | - Joël R Drevet
- GReD Institute, CNRS-INSERM-Université Clermont Auvergne, Faculty of Medicine, Clermont-Ferrand, France
| | - Marisa Dolhnikoff
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Raul Sanchez
- Center of Translational Medicine-Scientific and Technological Bioresource Nucleus (CEMT-BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Institute of Parasitology, Justus Liebig University Giessen, Giessen, Germany
| | - Paulo H N Saldiva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Chen F, Zhang Y, Zhang Y, Li Y, Ma J, Qin Y, Deng S, Zhang Y, Wang D, Wang H, Lin J. Effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus (COVID-19) vaccination on male fertility. Sex Health 2024; 21:SH23191. [PMID: 38538087 DOI: 10.1071/sh23191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024]
Abstract
Coronavirus disease 2019, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains an ongoing global public health challenge. This disease causes damage not only to the respiratory system, affecting the normal physiological function of the lungs, but also to other vital organs, such as the heart and testicles. Existing studies have shown that co-expression of angiotensin-converting enzyme 2 and transmembrane serine protease 2 is the main mechanism by which SARS-CoV-2 invades host cells. Angiotensin-converting enzyme 2-expressing cells are widespread in the corpus cavernosum, reproductive tract and testis of men, which has raised concerns. Furthermore, abnormal sex hormone levels and decreased semen parameters were observed in coronavirus disease 2019 patients. This study comprehensively assessed the effects of SARS-CoV-2 infection on the testis, semen parameters, sex hormone levels and erectile function, and discussed possible transmission routes during sexual intercourse and the effect of vaccination on male fertility.
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Affiliation(s)
- Fei Chen
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yunfei Zhang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yingze Zhang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yuqi Li
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Jiao Ma
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yining Qin
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Shuwen Deng
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Yuhan Zhang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Deyang Wang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Haiying Wang
- Jining Medical University, 133 Hehua Road, Jining 272067, China
| | - Juan Lin
- Jining Medical University, 133 Hehua Road, Jining 272067, China
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Dong Y, Ba Z, Qin Y, Ma J, Li Y, Zhang Y, Yang A, Chen F. Comprehensive evaluation of inactivated SARS-CoV-2 vaccination on sperm parameters and sex hormones. Front Immunol 2024; 15:1321406. [PMID: 38469318 PMCID: PMC10925671 DOI: 10.3389/fimmu.2024.1321406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 02/09/2024] [Indexed: 03/13/2024] Open
Abstract
Background The inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine has made significant contributions to fighting the epidemic in the past three years. However, the rapid development and application raised concerns about its safety in reproductive health, especially after several studies had observed a decrease in semen parameters following two doses of mRNA SARS-CoV-2 vaccination. Thus, it is necessary to comprehensively evaluate the effect of inactivated SARS-CoV-2 vaccine on male fertility. Methods A retrospective cohort study was conducted in the Center for Reproductive Medicine of the Affiliated Hospital of Jining Medical University between July 2021 and March 2023. A total of 409 men with different vaccination status and no history of SARS-CoV-2 infection were included in this study. Their sex hormone levels and semen parameters were evaluated and compared separately. Results The levels of FSH and PRL in one-dose vaccinated group were higher than other groups, while there were no significant changes in other sex hormone levels between the control and inactivated SARS-CoV-2 vaccinated groups. Most semen parameters such as volume, sperm concentration, total sperm count, progressive motility and normal forms were similar before and after vaccination with any single dose or combination of doses (all P > 0.05). Nevertheless, the total motility was significantly decreased after receiving the 1 + 2 doses of vaccine compared to before vaccination (46.90 ± 2.40% vs. 58.62 ± 2.51%; P = 0.001). Fortunately, this parameter was still within the normal range. Conclusion Our study demonstrated that any single dose or different combined doses of inactivated SARS-CoV-2 vaccination was not detrimental to male fertility. This information could reassure men who want to conceive after vaccination and be incorporated into future fertility recommendations.
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Affiliation(s)
- Yehao Dong
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Zaihua Ba
- Department of Physiology, Jining Medical University, Jining, China
| | - Yining Qin
- Department of Physiology, Jining Medical University, Jining, China
| | - Jiao Ma
- Department of Physiology, Jining Medical University, Jining, China
| | - Yuqi Li
- Department of Physiology, Jining Medical University, Jining, China
| | - Yingze Zhang
- Department of Physiology, Jining Medical University, Jining, China
| | - Aijun Yang
- Center for Reproductive Medicine, Affiliated Hospital of Jining Medical University, Jining, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, Jining, China
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Alzahrani MA, Alkhani KO, Alassaf AM, Alorainy JI, Binsaleh S, Almannie R. Updates in the pathophysiology of COVID-19 infection in male reproductive and sexual health: a literature review. Front Endocrinol (Lausanne) 2024; 14:1226858. [PMID: 38468633 PMCID: PMC10925715 DOI: 10.3389/fendo.2023.1226858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 12/26/2023] [Indexed: 03/13/2024] Open
Abstract
This extensive comprehensive review explores the impact of the Coronavirus disease 2019 (COVID-19) pandemic on men's sexual and reproductive health. We conducted a literature review focusing on the possible pathophysiology by which severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) affects men's sexual and reproductive systems. We reviewed most of the studies that reported the impact of SARS-CoV-2 infection on the Testicular, Epididymal, Prostatic, and Penile tissue. Also, we focused on evaluating the SARS-CoV-2 infection on semen parameters and male reproductive hormones. Finally, we reviewed the COVID-19 vaccine's effect on male reproductive and sexual health. Findings revealed the adverse consequences of SARS-CoV-2 at cellular and organ levels on the male genital tract. However, the reported data are still controversial. The initial data regarding COVID-19 vaccination was promising promoted safety for men's reproductive and sexual health. We conclude this paper by offering recommendations to address these adverse consequences and potentially improve sexual and reproductive health among men in the post-COVID-19 pandemic era.
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Affiliation(s)
- Meshari A. Alzahrani
- Department of Urology, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia
| | | | | | | | - Saleh Binsaleh
- Department of Surgery, Urology Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Raed Almannie
- Department of Surgery, Urology Division, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Hoffmann K, Gopal M. Paediatric acute epididymo-orchitis temporally related to SARS-CoV-2 infection: A case series and review of the literature. J Pediatr Urol 2024; 20:91-94. [PMID: 37806834 DOI: 10.1016/j.jpurol.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 08/18/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Acute epididymo-orchitis (AEO) is becoming an increasingly common differential diagnosis in children with acute scrotal pain. It has been noted in adult men that SARS-CoV-2 has a propensity for involving the testis and epididymis, affecting sperm and testosterone production. Our literature search revealed only one case report of COVID-19 presenting with epididymo-orchitis in a child. We present three more children who presented with AEO, all recovering from PCR-confirmed SARS-CoV-2 infection. This article reviews the post-inflammatory aetiology of paediatric epididymo-orchitis, and the propensity SARS-CoV-2 has for the testis. PATIENTS AND METHODS Two pre-pubertal ten-year-old patients presented to the emergency department with a 48-h history of gradual onset unilateral scrotal pain and increasing erythema of the ipsilateral scrotal skin. One fifteen-year-old boy was referred for ongoing symptoms four days following a diagnosis of AEO made by his General Practitioner. On further questioning, all three had PCR-confirmed COVID infection two weeks prior to the onset of their scrotal symptoms and had just ended their isolation period. A literature search was then performed using the keywords SARS-CoV-2, testes and paediatric acute epididymo-orchitis. DISCUSSION The SARS-Cov-2 virus has a propensity for affecting the testis and epididymis. This puts patients at increased risk of acute epididymo-orchitis during COVID infections. The inflammation induced by the virus appears to affect the cells responsible for testosterone production and sperm quality. However, there is no evidence that viral transmission can happen via semen. CONCLUSION SARS-Cov-2 infection can lead to acute epididymo-orchitis. Knowledge of this is clinically significant, firstly to avoid unnecessary surgical intervention due to a mistaken diagnosis of testicular torsion and secondly, due to the potential of the virus to affect sperm quality and testosterone production.
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Affiliation(s)
- Kelly Hoffmann
- Great North Children's Hospital, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, United Kingdom.
| | - Milan Gopal
- Great North Children's Hospital, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, United Kingdom
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Prasad A, Rashmi KG, Sahoo J, Kamalanathan S, Wyawahare M, Anusuya R, Naik D. Male Hypogonadism After Recovery from Acute COVID-19 Infection: A Prospective Observational Study. Exp Clin Endocrinol Diabetes 2024; 132:23-32. [PMID: 38049105 DOI: 10.1055/a-2201-8816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND The severe acute respiratory syndrome coronavirus 2 can affect the hypothalamic-pituitary-gonadal axis (HPG) due to the expression of the angiotensin-converting enzyme 2 receptor. OBJECTIVES To assess the prevalence of hypogonadism and Sertoli cell dysfunction in coronavirus disease 2019 (COVID-19) male survivors. METHOD Male subjects recovered from acute COVID-19 infection were prospectively observed. The primary outcomes included the proportion of hypogonadism, defined biochemically as serum testosterone<230 ng/dL or CFT of<6.4 ng/mL if the total testosterone is between 230-320 ng/m. Sertoli cell dysfunction was defined as inhibin-B level<54.5 pg/mL. Subjects with hypogonadism were followed up at 12 months to assess the recovery of the HPG axis. RESULTS Eighty-three subjects aged≥18 years were evaluated at a median of 120 (±35) days post-recovery. Their mean age was 49.50±12.73 years, and the mean BMI was 26.84±5.62 kg/m2. Low testosterone was detected in 21 (24.71%) and low inhibin-B was detected in 14 (19.71%) out of 71 subjects at 3 months. Subjects with low testosterone were younger, with a mean age of 43.29±12.03 years (P-0.08) and higher BMI (P-0.012). The severity of COVID-19 infection, duration of hospitalization, and other factors were not significantly associated with low testosterone. At 12 months, 18 out of 21 subjects came for follow-up, of which 9 (50%) showed persistently low testosterone, suggestive of hypogonadism. CONCLUSION Following COVID-19 infection, testosterone levels recovered over time; however, a significant proportion of subjects had low levels at 12-month follow-up. These findings have long-term implications for the management of COVID-19 subjects.
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Affiliation(s)
- Aravind Prasad
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - K G Rashmi
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Mukta Wyawahare
- Department of Internal Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - R Anusuya
- Department of Biostatistics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dukhabandhu Naik
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Kervancioglu Demirci E, Dursun M, Seviç E, Ergül RB, Önel M, Ağaçfidan A, Kadıoğlu A. Evidence for residual SARS-CoV-2 in corpus cavernosum of patients who recovered from COVID-19 infection. Andrology 2023; 11:1016-1022. [PMID: 36426580 DOI: 10.1111/andr.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 is an ongoing health problem with millions of cases and deaths worldwide. Although the virus is transmitted with droplets through the respiratory system, the involvement of different organs has been reported. OBJECTIVES The pandemic caused urological procedures to be postponed when patient is infected with SARS-CoV-2. However, the reliability of 1 month postpone period and long-term complications of the virus, such as a possible erectile dysfunction (ED) is not clarified. We aimed to compare the corpus cavernosum of patients 1 and 7 months after COVID-19 infection with control patients who had not COVID-19 and search for SARS-CoV-2 in tissues using immunohistochemistry and electron microscopy. MATERIALS AND METHODS Three groups of subjects underwent penile prosthesis implantation and Nesbit procedure for Peyronie's disease 1 and 7 months after COVID-19 infection and control group without previous COVID-19 infection. We searched for SARS-CoV-2 in penile tissue using RT-PCR, electron microscopy and immunohistochemistry. RESULTS Electron microscopy and immunohistochemical staining showed SARS CoV-2 virus in the penile corpus cavernosum of patients 1 month after COVID-19 recovery. Immunohistochemical staining intensity correlated with the severity of previous infection. Transmission electron microscopy revealed intracellular virtual particles of about 80 nm with a typical morphology of prominent spikes and electron-dense dots of nucleocapsid in addition to vesicles filled with virus-like particles. Cells showed increased membrane trafficking. The 1 month after COVID-19 group showed an increased number of fibroblasts. The 7 months after COVID-19 group had similar morphology and immunoreactivity as control group. DISCUSSION This is the first study of late post-COVID examination of penis and the second study of early post-COVID examination of corpus cavernosum. For 1 month post-COVID patients, the aetiology of ED could be the viral infection that is also affecting corpora cavernosa. We hypothesize that viral infection affects the endocytic and exocytic pathways, hence the metabolic activity of cells that can be the reason of altered functions in some post-COVID patients. CONCLUSION This study is important because it did not detect any virus residue in the tissue samples at the seventh month. In addition, we can say that the penile surgeries should be postponed more than 1 month after the COVID infection according to this study. But, there is a need for new studies with large series and high levels of evidence that can show how long the virus remains in the corpus cavernosum. Patients should be followed in this respect.
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Affiliation(s)
- Elif Kervancioglu Demirci
- Department of Histology and Embryology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Dursun
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erva Seviç
- Department of Histology and Embryology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Rıfat Burak Ergül
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Önel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ağaçfidan
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ateş Kadıoğlu
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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10
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Cakir C, Kuspinar G, Kurt G, Berber M, Aslan K, Kasapoglu I, Uncu G, Avcı B. Comparison of semen parameters in the same patients before and after diagnosis of COVID-19. J Med Virol 2023; 95:e29094. [PMID: 37695129 DOI: 10.1002/jmv.29094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/31/2023] [Accepted: 08/31/2023] [Indexed: 09/12/2023]
Abstract
Clinical and histopathological evidence suggest that the male reproductive system may be negatively impacted in patients with coronavirus disease (COVID-19). The objective of this study is to investigate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on semen parameters by comparing semen analyses before and after COVID-19 diagnosis in the same patient. We retrospectively analyzed 342 semen analyses by reviewing medical records. The study included two groups of patients: (i) those who underwent two consecutive semen analyses within 6 months, one before (n = 114) and one after (n = 114) COVID-19 diagnosis, and (ii) a control group (n = 114) that was age-matched and did not receive a diagnosis of COVID-19. The study results indicated a significant decrease in semen volume, total sperm count per ejaculate, progressive motile sperm count, total motile sperm count, and normal sperm morphology after SARS-CoV-2 infection in comparison to their respective values before the infection. Subgroup analyses showed that the duration of COVID-19 diagnosis (short-term vs. long-term) did not impact the changes in semen parameters. However, fever during the COVID-19 process had a negative effect on semen parameters, particularly sperm concentration, unlike in patients without fever. In conclusion, our findings suggest that SARS-CoV-2 infection is associated with a decline in semen quality, which may potentially impact male fertility. Furthermore, it's important to note that the negative effects on semen parameters may persist in the long-term. Our results also indicate that fever during active infection could be a significant risk factor that negatively affects spermatogenesis.
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Affiliation(s)
- Cihan Cakir
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Goktan Kuspinar
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Gizem Kurt
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Miray Berber
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Kiper Aslan
- Department of Obstetrics and Gynecology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Isil Kasapoglu
- Department of Obstetrics and Gynecology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Gurkan Uncu
- Department of Obstetrics and Gynecology, Uludag University School of Medicine, ART Center, Bursa, Turkey
| | - Berrin Avcı
- Department of Histology and Embryology, Uludag University School of Medicine, ART Center, Bursa, Turkey
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11
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Dai P, Qiao F, Chen Y, Chan DYL, Yim HCH, Fok KL, Chen H. SARS-CoV-2 and male infertility: from short- to long-term impacts. J Endocrinol Invest 2023; 46:1491-1507. [PMID: 36917421 PMCID: PMC10013302 DOI: 10.1007/s40618-023-02055-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/01/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE The coronavirus 2019 (COVID-19) pandemic-caused by a new type of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-has posed severe impacts on public health worldwide and has resulted in a total of > 6 million deaths. Notably, male patients developed more complications and had mortality rates ~ 77% higher than those of female patients. The extensive expression of the SARS-CoV-2 receptor and related proteins in the male reproductive tract and the association of serum testosterone levels with viral entry and infection have brought attention to COVID-19's effects on male fertility. METHODS The peer-reviewed articles and reviews were obtained by searching for the keywords SARS-CoV-2, COVID-19, endocrine, spermatogenesis, epididymis, prostate, and vaccine in the databases of PubMed, Web of Science and Google Scholar from 2020-2022. RESULTS This review summarizes the effects of COVID-19 on the male reproductive system and investigates the impact of various types of SARS-CoV-2 vaccines on male reproductive health. We also present the underlying mechanisms by which SARS-CoV-2 affects male reproduction and discuss the potentially harmful effects of asymptomatic infections, as well as the long-term impact of COVID-19 on male reproductive health. CONCLUSION COVID-19 disrupted the HPG axis, which had negative impacts on spermatogenesis and the epididymis, albeit further investigations need to be performed. The development of vaccines against various SARS-CoV-2 variations is important to lower infection rates and long-term COVID risks.
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Affiliation(s)
- P Dai
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China
| | - F Qiao
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China
| | - Y Chen
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China
| | - D Y L Chan
- Assisted Reproductive Technologies Unit, Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - H C H Yim
- Microbiome Research Centre, School of Clinical Medicine, Faculty of Medicine, St George and Sutherland Campus, UNSW Sydney, Sydney, Australia
| | - K L Fok
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.
- Kong Joint Laboratory for Reproductive Medicine, Sichuan University-The Chinese University of Hong, West China Second University Hospital, Chengdu, People's Republic of China.
| | - H Chen
- Institute of Reproductive Medicine, Medical School of Nantong University, Nantong, People's Republic of China.
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12
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Guiton R, Drevet JR. Viruses, bacteria and parasites: infection of the male genital tract and fertility. Basic Clin Androl 2023; 33:19. [PMID: 37468865 DOI: 10.1186/s12610-023-00193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/05/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Infertility affects one couple out of six worldwide. Male infertilty can result from congenital or acquired factors, of which pathogens that reach the genital tract through sexual contact or blood dissemination. The impact of major viral, bacterial and parasitic infections on the male genital tract and fertility has been summarized. RESULTS AND CONCLUSIONS A systematic review of articles published in the Google Scholar and PubMed databases was conducted. It turns out that viruses, as well as bacteria and parasites are major inducers of male genital tract infections and ensuing infertility through damage to the organs and subsequent loss of function and/or through direct damage to the sperm cells. Moreover, not only male infertility results from such infections but these can also be transmitted to women and even to the offspring, thus highlighting the need to efficiently detect, treat and prevent them.
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Affiliation(s)
- Rachel Guiton
- Université Clermont Auvergne, CNRS UMR6293, GReD Institute, 63001, Clermont-Ferrand, France.
| | - Joël R Drevet
- Université Clermont Auvergne, CNRS UMR6293, GReD Institute, 63001, Clermont-Ferrand, France
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13
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Leng T, Guo Z, Sang Z, Xin Q, Chen F. Effect of COVID-19 on sperm parameters: pathologic alterations and underlying mechanisms. J Assist Reprod Genet 2023:10.1007/s10815-023-02795-y. [PMID: 37115332 PMCID: PMC10140716 DOI: 10.1007/s10815-023-02795-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
The rapid outbreak of the coronavirus disease 2019 (COVID-19) pandemic has brought challenges to different medical fields, especially reproductive health. To date, most studies on the effects of COVID-19 on male reproduction have some limitations. In addition, there is little research on the mechanisms underlying by which severe acute respiratory syndrome coronavirus 2 infection affects semen quality. Here, we revealed the possible impact of COVID-19 on sperm parameters and the potential mechanisms. At present, it is still controversial whether COVID-19-induced fever adversely affects sperm parameters. Severe acute respiratory syndrome coronavirus 2 can induce up-regulation of pro-inflammatory cytokine, which leads to the destruction of blood-testis barrier and impairment of spermatogenesis. Moreover, severe viral infection of the respiratory system could induce systemic oxidative stress. Sperm are highly vulnerable to it due to their limited levels of antioxidant defense, unsophisticated DNA damage detection and repair mechanisms. Our review prompt medical staff and patients to consciously check the reproductive function of COVID-19 male patients. Moreover, opening our prospective beyond the direct infection could be the key to better understand the COVID-19 short and long-term effects and provide a new idea for future treatment of patients with reproductive function injury.
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Affiliation(s)
- Taiyang Leng
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Zhihui Guo
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Ziling Sang
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Qing Xin
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China
| | - Fei Chen
- Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China.
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14
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Xu CS, Yang WX. ACE2 in male genitourinary and endocrine systems: Does COVID-19 really affect these systems? Histol Histopathol 2023; 38:261-272. [PMID: 36069179 DOI: 10.14670/hh-18-510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
The virus that causes COVID-19 (Corona Virus Disease 2019), SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), is causing a worldwide pandemic, posing a substantial threat to human health. Patients show signs of pneumonia, ARDS, shock, acute cardiac injury, acute kidney injury and other complications. The SARS-CoV-2 receptor is angiotensin converting enzyme 2 (ACE2), which is an important component of the renin-angiotensin system (RAS). In addition, TMPRSS2 or other cofactors are needed to allow the virus to enter the host. Clinical patients have exhibited varying degrees of genitourinary and endocrine system damage, and some studies have also reported potential risks to the genitourinary and endocrine systems. This article reviews the mechanism underlying SARS-CoV-2 infection and the current studies on the male genitourinary and endocrine systems and proposes that more attention should be directed towards human reproductive and endocrine health during the SARS-CoV-2 epidemic.
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Affiliation(s)
- Chen-Shuo Xu
- The Sperm Laboratory, College of Life Sciences, Zhejiang University, Hangzhou, China
| | - Wan-Xi Yang
- The Sperm Laboratory, College of Life Sciences, Zhejiang University, Hangzhou, China.
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15
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Chen F, Hao L, Zheng K, Zhu S, Dai Z, Shi W, Wang X, Li X, Yang X, Zhao Q. Potential influence of COVID-19 and dexamethasone on the reproductive system: what we know and can expect. HUM FERTIL 2022:1-12. [DOI: 10.1080/14647273.2022.2142919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Fei Chen
- Department of Physiology, Jining Medical University, Jining, China
| | - Lanting Hao
- Department of Physiology, Jining Medical University, Jining, China
| | - Kai Zheng
- Department of Physiology, Jining Medical University, Jining, China
| | - Shiheng Zhu
- Department of Physiology, Jining Medical University, Jining, China
| | - Zhiqing Dai
- Department of Physiology, Jining Medical University, Jining, China
| | - Wenhao Shi
- Department of Physiology, Jining Medical University, Jining, China
| | - Xinyi Wang
- Department of Physiology, Jining Medical University, Jining, China
| | - Xinya Li
- Department of Physiology, Jining Medical University, Jining, China
| | - Xinyuan Yang
- Department of Physiology, Jining Medical University, Jining, China
| | - Qian Zhao
- Department of Physiology, Jining Medical University, Jining, China
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16
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Aydin S, Tokur O, Kazci O, Ece B, Karavas E, Kantarci M. Sonographic findings of COVID-19 related acute scrotal infection and associations with clinical-laboratory data. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1385-1390. [PMID: 35775362 PMCID: PMC9349983 DOI: 10.1002/jcu.23263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/15/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND During the Coronavirus Disease 2019 (COVID-19) pandemic, patients present to hospitals with a wide range of symptoms. Some of these symptoms include acute orchitis and epididymitis. The goal of this research is to see if COVID-19 infection and scrotal infection are associated. MATERIALS AND METHODS Patients with a COVID-19 (+) who agreed to a scrotal ultrasound (US) examination were studied prospectively in a tertiary care center between October 2021 and February 2022. The severity of the disease was used to divide patients into groups. Patients diagnosed with acute scrotal infection based on scrotal ultrasonography findings were compared in these groups, as were their age, comorbidities, and laboratory data. RESULTS The median age of the 213 participants was 61.7 ± 8.3. During the ultrasonographic examination of the patients, 15 (7%), 8 (3.7%), 17 (7.9%), and 40 (18.7%) were diagnosed with acute orchitis, acute epididymitis, acute epididymo-orchitis, and scrotal infection, respectively. Acute scrotal infection was far more common in patients with a higher clinical severity of the disease. The patients' comorbidities were also assessed, and it was discovered that they were statistically more common in the same group. CONCLUSIONS Even if there are no clinical symptoms, ultrasonography can help detect acute scrotal infection in COVID-19 patients. Furthermore, in groups with higher clinical severity, this association is more likely to be seen. It is critical to understand this in order to avoid complications.
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Affiliation(s)
- Sonay Aydin
- Department of RadiologyErzincan UniversityErzincanTurkey
| | - Oğuzhan Tokur
- Department of RadiologyAnkara Training and Research HospitalAnkaraTurkey
| | - Omer Kazci
- Department of RadiologyYuksek Ihtisas UniversityAnkaraTurkey
| | - Bunyamin Ece
- Department of RadiologyKastamonu UniversityKastamonuTurkey
| | - Erdal Karavas
- Department of RadiologyErzincan UniversityErzincanTurkey
| | - Mecit Kantarci
- Department of RadiologyErzincan UniversityErzincanTurkey
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17
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Ohkubo Y, Ohmura SI, Ishihara R, Miyamoto T. Possible case of polyarteritis nodosa with epididymitis following COVID-19 vaccination: A case report and review of the literature. Mod Rheumatol Case Rep 2022; 7:172-176. [PMID: 36305628 PMCID: PMC9620383 DOI: 10.1093/mrcr/rxac085] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/21/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Abstract
The global outbreak of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 has prompted the rapid spread and development of vaccines to prevent the spread of the disease. COVID-19 vaccine has demonstrated excellent efficacy in reducing morbidity and severity of the disease, and most adverse reactions are very minor. However, some patients have been reported to develop autoimmune diseases, such as rheumatoid arthritis, myocarditis, Guillain-Barre syndrome, and vasculitis, following COVID-19 vaccination. Herein, we present a case of polyarteritis nodosa with epididymitis, following COVID-19 mRNA vaccination. The patient's initial symptoms were fever and testicular pain, and magnetic resonance imaging showed epididymitis. He was diagnosed as having polyarteritis nodosa with epididymitis and was treated with high-dose prednisolone, with a good clinical outcome.
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Affiliation(s)
- Yusuke Ohkubo
- Department of Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu Shizuoka, Japan
| | - Shin-ichiro Ohmura
- correspondence to: Shin-ichiro Ohmura, Division of Rheumatology, Seirei Hamamatsu General Hospital,2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430–8558, Japan E-mail:
| | - Ryuhei Ishihara
- Department of Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu Shizuoka, Japan
| | - Toshiaki Miyamoto
- Department of Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu Shizuoka, Japan
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18
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Tristão LS, Bresler R, Modesto VA, Fernandes RDC, Bernardo WM. Urological complications of COVID-19: a systematic review. Int Braz J Urol 2022; 49:24-40. [PMID: 36512453 PMCID: PMC9881803 DOI: 10.1590/s1677-5538.ibju.2022.0281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE COVID-19 continues to be an urgent World issue. Receptors of angiotensin converting enzyme 2 (ACE2), gateway of SARS-CoV-2, are present in the lungs, bladder, prostate, and testicles. Therefore, these organs face high risk of damage caused by the virus and this mechanism may explain non-respiratory symptoms of the disease. MATERIALS AND METHODS This systematic review, guided by the PRIMSA statement, was proposed to elucidate possible urological complications of COVID-19. Searches were carried out in Medline (PubMed), Cochrane (CENTRAL), Embase, MedRxiv and LILACS. Bias analysis was made using the specific Newcastle-Ottawa Scale for each study design. RESULTS Search was carried out until April 2022, and 8,477 articles were identified. Forty-nine of them were included in this systematic review. There is evidence that lower urinary tract symptoms and acute scrotum may be signs of COVID-19 in men, although in a small proportion. Also, the disease may have a transitory impact on male fertility, evidenced by several alterations in sperm counts. However, it must be clarified whether this impact is transitory, or may last for longer periods. Several patients showed reduction of total value of testosterone. Two authors linked low levels of testosterone with worse outcomes of COVID-19, suggesting that the hormone may be used as an early biomarker of the severity of the disease. Moreover, it is extremely unlikely that SARS-CoV-2 is transmitted by semen. CONCLUSION This systematic review identified possible repercussions of COVID-19 in the urinary as well as in the male reproductive system.
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Affiliation(s)
- Luca Schiliró Tristão
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil,Correspondence address: Luca Schiliró Tristão, MD, Departamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos – UNILUS, R. Oswaldo Cruz, 179 – Boqueirão Santos, SP, 11045-101, Brasil. Telephone: +5511 9 6915-6070 E-mail:
| | - Rafael Bresler
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil
| | - Victoria Andrade Modesto
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil
| | - Roni de Carvalho Fernandes
- Divisão de UrologiaSanta Casa de São PauloSão PauloSPBrasilDivisão de Urologia, Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Wanderley Marques Bernardo
- Faculdade de Ciências Médicas de SantosDepartamento de Medicina Baseada em EvidênciasSantosSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil,Faculdade de Medicina da Universidade de São PauloDepartamento de Medicina Baseada em EvidênciasSão PauloSPBrasilDepartamento de Medicina Baseada em Evidências, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil
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19
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Drevet JR, Hallak J, Nasr-Esfahani MH, Aitken RJ. Reactive Oxygen Species and Their Consequences on the Structure and Function of Mammalian Spermatozoa. Antioxid Redox Signal 2022; 37:481-500. [PMID: 34913729 DOI: 10.1089/ars.2021.0235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Significance: Among the 200 or so cell types that comprise mammals, spermatozoa have an ambiguous relationship with the reactive oxygen species (ROS) inherent in the consumption of oxygen that supports aerobic metabolism. Recent Advances: In this review, we shall see that spermatozoa need the action of ROS to reach their structural and functional maturity, but that due to intrinsic unique characteristics, they are, perhaps more than any other cell type, susceptible to oxidative damage. Recent studies have improved our knowledge of how oxidative damage affects sperm structures and functions. The focus of this review will be on how genetic and epigenetic oxidative alterations to spermatozoa can have dramatic unintended consequences in terms of both the support and the suppression of sperm function. Critical Issues: Oxidative stress can have dramatic consequences not only for the spermatozoon itself, but also, and above all, on its primary objective, which is to carry out fertilization and to ensure, in part, that the embryonic development program should lead to a healthy progeny. Future Directions: Sperm oxidative DNA damage largely affects the integrity of the paternal genetic material to such an extent that the oocyte may have difficulties in correcting it. Diagnostic and therapeutic actions should be considered more systematically, especially in men with difficulties to conceive. Research is underway to determine whether the epigenetic information carried by spermatozoa is also subject to changes mediated by pro-oxidative situations. Antioxid. Redox Signal. 37, 481-500.
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Affiliation(s)
- Joël R Drevet
- Faculty of Medicine, GReD Institute, INSERM U1103-CNRS UMR6293-Université Clermont Auvergne, Clermont-Ferrand, France
| | - Jorge Hallak
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo, Brazil.,Division of Urology, University of São Paulo, São Paulo, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo, Brazil.,Reproductive Toxicology Unit, Department of Pathology, University of São Paulo, São Paulo, Brazil
| | - Mohammad-Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran.,Isfahan Fertility and Infertility Center, Isfahan, Iran
| | - Robert J Aitken
- Faculty of Science and Priority Research Center for Reproductive Sciences, The University of Newcastle, Callaghan, Australia.,Faculty of Health and Medicine, Priority Research Center for Reproductive Sciences, The University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia
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20
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Lucio Carrasco CH, Noda P, Barbosa AP, Vieira Borges da Silva EK, Gasque Bomfim C, Ventura Fernandes BH, Teixeira TA, Nunes Duarte Neto A, Nascimento Saldiva PH, Achoa Filho K, Rodrigues Guzzo C, Durigon EL, Affonso Fonseca FL, Corazzini R, Fanelli C, Noronha IL, Hallak J. SARS-CoV-2 Nucleocapsid Protein is Associated With Lower Testosterone Levels: An Experimental Study. Front Physiol 2022; 13:867444. [PMID: 35721551 PMCID: PMC9204174 DOI: 10.3389/fphys.2022.867444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
The ongoing COVID-19 pandemic represents an extra burden in the majority of public and private health systems worldwide beyond the most pessimistic expectations, driving an urgent rush to develop effective vaccines and effective medical treatments against the SARS-CoV-2 pandemic. The Nucleocapsid structural viral protein is remarkably immunogenic and hugely expressed during infection. High IgG antibodies against Nucleocapsid protein (N protein) levels were detected in the serum of COVID-19 patients, confirming its pivotal antigen role for a T lymphocyte response in a vaccine microenvironment. Currently, adverse events associated with immunizations have raised some degree of concern, irrespective of its huge benefits in dealing with disease severity and decreasing mortality and morbidity. This hitherto study evaluates histological changes in rats’ testes, epididymis, prostate, and seminal vesicles and analyzes hormone levels after solely N protein inoculation. Therefore, we exposed a group of Lewis rats to weekly injections of the recombinant N protein for 28 days, while a control group was inoculated with a buffer solution. The N group revealed a more significant number of spermatozoa. Spermatozoa in the seminiferous tubules were counted in twenty 400 × microscopy fields (mean of 9.2 vs. 4.6 in the control group; p < 0,01), but significantly lower testosterone levels (mean of 125.70 ng/dl vs. 309,00 ng/dl in the control group; p < 0,05) were found. No other histological and biochemical changes were displayed. Conclusively, these data suggest testicular hormonal imbalance mediated by the SARS-CoV-2 N protein that could be linked to reported post-COVID-19 syndrome hypogonadism. More relevant research might be performed to confirm this viral antigen’s deleterious mechanism in the human testicular microenvironment, particular in Leydig cell function.
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Affiliation(s)
- Caio Henrique Lucio Carrasco
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Hospital Das Clinicas, University of Sao Paulo Medical School, Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
| | - Paloma Noda
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ana Paula Barbosa
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Camila Gasque Bomfim
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Thiago Afonso Teixeira
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Hospital Das Clinicas, University of Sao Paulo Medical School, Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
| | - Amaro Nunes Duarte Neto
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - Paulo Hilario Nascimento Saldiva
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
- Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
| | - Kamal Achoa Filho
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Cristiane Rodrigues Guzzo
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Roseli Corazzini
- Department of Clinical Laboratory, University Center of ABC Medical School, Santo Andre, Brazil
| | - Camilla Fanelli
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Irene Lourdes Noronha
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jorge Hallak
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Hospital Das Clinicas, University of Sao Paulo Medical School, Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
- Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
- *Correspondence: Jorge Hallak,
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21
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Ebner B, Volz Y, Mumm JN, Stief CG, Magistro G. The COVID-19 pandemic - what have urologists learned? Nat Rev Urol 2022; 19:344-356. [PMID: 35418709 PMCID: PMC9007269 DOI: 10.1038/s41585-022-00586-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 12/18/2022]
Abstract
On 11 March 2020, the WHO declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic and COVID-19 emerged as one of the biggest challenges in public health and economy in the twenty-first century. The respiratory tract has been the centre of attention, but COVID-19-associated complications affecting the genitourinary tract are reported frequently, raising concerns about possible long-term damage in these organs. The angiotensin-converting enzyme 2 (ACE2) receptor, which has a central role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion, is highly expressed in the genitourinary tract, indicating that these organs could be at a high risk of cell damage. The detection of SARS-CoV-2 in urine and semen is very rare; however, COVID-19 can manifest through urological symptoms and complications, including acute kidney injury (AKI), which is associated with poor survival, severe structural changes in testes and impairment of spermatogenesis, and hormonal imbalances (mostly secondary hypogonadism). The effect of altered total testosterone levels or androgen deprivation therapy on survival of patients with COVID-19 was intensively debated at the beginning of the pandemic; however, androgen inhibition did not show any effect in preventing or treating COVID-19 in a clinical study. Thus, urologists have a crucial role in detecting and managing damage of the genitourinary tract caused by COVID-19.
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Affiliation(s)
- Benedikt Ebner
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Yannic Volz
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Jan-Niclas Mumm
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany
| | - Giuseppe Magistro
- Department of Urology, Ludwig-Maximilians-University, Munich, Germany.
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22
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Andersen ML, Tufik S. The Association Between Sleep Disturbances and Erectile Dysfunction During the COVID-19 Pandemic. Sex Med Rev 2021; 10:263-270. [PMID: 35042659 PMCID: PMC8677465 DOI: 10.1016/j.sxmr.2021.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/02/2021] [Accepted: 12/05/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION There is increasing concern about the impact of the SARS-CoV-2 pandemic on mental and physical health. Among the many possible outcomes of COVID-19, reports of sleep disturbances, and erectile dysfunction are becoming prevalent worldwide. OBJECTIVES We sought to evaluate the recent literature on this subject to produce a narrative review of the topic. METHODS We performed an extensive literature search to identify recent scientific findings on this subject. RESULTS To date, the precise mechanisms that trigger pandemic related sexual dysfunction are not completely understood, although it has been suggested that psychogenic effects play an important role, in addition to the direct effects of the disease itself on those infected. There is evidence that the stress induced by the pandemic has had a significant impact on sleep, and sleep disturbances are known to induce erectile dysfunction. Other mechanisms which trigger this phenomenon, such as hormonal changes and previous health conditions, have been suggested to be associated with SARS-CoV-2 infection, and these factors may have a potential link to sleep disturbance. CONCLUSION The combined effect of COVID-19 and the psychogenic disorders triggered by isolation, grief, and anxiety might be associated with the increased prevalence of erectile dysfunction. This feature might be worsened by the onset of pre-existing or pandemic-induced sleep disorders. However, few studies explored this subject. Understanding this phenomenon is important for the strategic planning of treatments that could improve the quality of life of the population. Andersen ML, Tufik S. The Association Between Sleep Disturbances and Erectile Dysfunction During the COVID-19 Pandemic. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil.
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, Brazil
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23
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Banihani SA. Human semen quality as affected by SARS-CoV-2 infection: An up-to-date review. Andrologia 2021; 54:e14295. [PMID: 34716614 PMCID: PMC8646253 DOI: 10.1111/and.14295] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/09/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022] Open
Abstract
Revealing the effect of SARS‐CoV‐2 infection on semen quality is a dynamic priority for many healthcare providers in the field as well as subfertile patients. Therefore, the collective summary in this research approach is still highly needed, especially with the continuous increase in original publications. Here, we provide an up‐to‐date review and discussion to collectively reveal the effect of SARS‐CoV‐2 infection on human semen quality. To do this, we reviewed all articles and abstracts published in Scopus and PubMed using the keywords ‘SARS‐CoV‐2’ and ‘COVID’ versus ‘sperm’ and ‘semen’. In summary, it can be revealed that, at both symptomatic and recovery stages of infection, no investigational evidence of SARS‐CoV‐2 shedding in human semen. Also, the mainstream of the up‐to‐date published work reveals a negative impact of SARS‐CoV‐2 infection on semen quality parameters, particularly sperm count and motility. However, long‐term post‐recovery comparative studies seem very important in this particular setting.
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Affiliation(s)
- Saleem Ali Banihani
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
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24
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Kgatle MM, Lawal IO, Mashabela G, Boshomane TMG, Koatale PC, Mahasha PW, Ndlovu H, Vorster M, Rodrigues HG, Zeevaart JR, Gordon S, Moura-Alves P, Sathekge MM. COVID-19 Is a Multi-Organ Aggressor: Epigenetic and Clinical Marks. Front Immunol 2021; 12:752380. [PMID: 34691068 PMCID: PMC8531724 DOI: 10.3389/fimmu.2021.752380] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022] Open
Abstract
The progression of coronavirus disease 2019 (COVID-19), resulting from a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, may be influenced by both genetic and environmental factors. Several viruses hijack the host genome machinery for their own advantage and survival, and similar phenomena might occur upon SARS-CoV-2 infection. Severe cases of COVID-19 may be driven by metabolic and epigenetic driven mechanisms, including DNA methylation and histone/chromatin alterations. These epigenetic phenomena may respond to enhanced viral replication and mediate persistent long-term infection and clinical phenotypes associated with severe COVID-19 cases and fatalities. Understanding the epigenetic events involved, and their clinical significance, may provide novel insights valuable for the therapeutic control and management of the COVID-19 pandemic. This review highlights different epigenetic marks potentially associated with COVID-19 development, clinical manifestation, and progression.
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Affiliation(s)
- Mankgopo Magdeline Kgatle
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Ismaheel Opeyemi Lawal
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, Steve Biko Academic Hospital, Pretoria, South Africa
| | - Gabriel Mashabela
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DSI/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Tebatso Moshoeu Gillian Boshomane
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, Steve Biko Academic Hospital, Pretoria, South Africa
- Nuclear and Oncology Division, AXIM Medical (Pty), Midrand
| | - Palesa Caroline Koatale
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Phetole Walter Mahasha
- Precision Medicine and SAMRC Genomic Centre, Grants, Innovation, and Product Development (GIPD) Unit, South African Medical Research Council, Pretoria, South Africa
| | - Honest Ndlovu
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Hosana Gomes Rodrigues
- Laboratory of Nutrients and Tissue Repair, School of Applied Sciences, University of Campinas, Campinas, Brazil
| | - Jan Rijn Zeevaart
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- South African Nuclear Energy Corporation, Radiochemistry and NuMeRI PreClinical Imaging Facility, Mahikeng, South Africa
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Siamon Gordon
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Pedro Moura-Alves
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mike Machaba Sathekge
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DSI/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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25
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Hezavehei M, Shokoohian B, Nasr-Esfahani MH, Shpichka A, Timashev P, Shahverdi AH, Vosough M. Possible Male Reproduction Complications after Coronavirus Pandemic. CELL JOURNAL 2021; 23:382-388. [PMID: 34455712 PMCID: PMC8405085 DOI: 10.22074/cellj.2021.7982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/29/2021] [Indexed: 12/23/2022]
Abstract
Coronavirus disease 2019 (COVID-19), as a severe respiratory disease, affects various tissues and organs. The
specific SARS-CoV-2 receptor, angiotensin-converting enzyme 2 (ACE2), is highly expressed in male gonads. Thus,
male reproductive tissues could be a potential target for virus colonization. We performed a comprehensive search in
PubMed and Google Scholar to retrieve relevant articles published till 15 April 2021. The keywords used were: male
fertility, male reproductive health, semen parameters, sex hormones, SARS-CoV-2, and COVID-19. Validated evidence
about the adverse effects of the SARS-CoV-2 infection on the male reproductive system is limited and few studies have
reported semen analysis results or presence of viral RNA in semen samples of infected men. Nevertheless, alterations
in reproductive hormones such as decreased level of testosterone (T) with raised luteinizing hormone (LH) have been
reported in some patients. Although the impact of SARS-CoV-2 infection on the male reproduction health remains
unclear, evidence suggests that male gonads may be potentially vulnerable to SARS-CoV-2 infection. In this article,
we discussed the possible impacts of COVID-19 on male gonads, sex hormones, and semen quality and suggested
preventive solutions.
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Affiliation(s)
- Maryam Hezavehei
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Bahare Shokoohian
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | | | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, Moscow, Russian
| | - Abdol Hossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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26
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Falahieh FM, Zarabadipour M, Mirani M, Abdiyan M, Dinparvar M, Alizadeh H, Paktinat S, Hosseinirad H. Effects of moderate COVID-19 infection on semen oxidative status and parameters 14 and 120 days after diagnosis. Reprod Fertil Dev 2021; 33:683-690. [PMID: 34324827 DOI: 10.1071/rd21153] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/03/2021] [Indexed: 12/27/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus causing coronavirus disease 2019 (COVID-19). Because COVID-19 is a multisystem infection, there are some concerns regarding its possible effects on male fertility. This study aimed to investigate the effects of COVID-19 on semen oxidative status and parameters 14 and 120 days after diagnosis in patients presenting with moderate infection (defined as respiratory symptoms, with or without fever, with Spo2 <93% and >90% and lung involvement <50%). Semen samples were obtained from 20 participants at two time points: the first sample on Day 14 and the second on Day 120 after diagnosis. Semen parameters (sperm concentration, motility, morphology, and viability) were evaluated, as were levels of seminal reactive oxygen species (ROS), malondialdehyde (MDA), total antioxidant capacity (TAC) and sperm DNA fragmentation. Semen parameters, including sperm motility and DNA integrity, improved at 120 days after the COVID-19 diagnosis relative to values at 14 days. In addition, ROS and MDA levels were significantly reduced in patients 120 days after infection, and TAC increased at 120 days compared with 14 days (during the acute stage of infection). In conclusion, the present study shows that the detrimental effects of COVID-19 on sperm properties caused by oxidative stress decrease up to Day 120 after diagnosis.
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Affiliation(s)
| | - Mahsa Zarabadipour
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Mirani
- Department of Reproductive Biology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Milad Abdiyan
- Department of Biotechnology, Faculty of Chemistry, University of Kashan, Kashan, Iran
| | - Marziyeh Dinparvar
- Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamideh Alizadeh
- Department of Internal Medicine, Imam Khomeini University Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Shahrokh Paktinat
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hosseinirad
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and Corresponding author.
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27
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[Viral infections in urology]. Urologe A 2021; 60:1150-1158. [PMID: 34228144 PMCID: PMC8258472 DOI: 10.1007/s00120-021-01589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/25/2022]
Abstract
Einleitung Die COVID-19-Pandemie („coronavirus disease 2019“) hat eindrucksvoll gezeigt, dass Infektionskrankheiten enorme Auswirkungen auf das Gesundheitswesen und darüber hinaus haben können. In der Urologie spielen Viren bei spezifischen Entitäten eine Rolle, wo sich der Urologe mit Viruserkrankungen beschäftigen muss. Methodik Diese Übersichtsarbeit hat zum Ziel in der Urologie relevante Virusinfektionen zu beschreiben und insbesondere die Impfprävention hervorzuheben. Es erfolgte eine selektive Literaturrecherche zu den Themen „COVID und Urologie“, „Urogenitale Virusinfektionen“, „Virale urologische Infektionen in der Transplantationsmedizin“ sowie „Impfprävention von Viruserkrankungen“. Ergebnisse Coronaviren sind Viren, die bereits 2‑mal lokale Epidemien verursacht haben (SARS- [„severe acute respiratory syndrome“] und MERS-Epidemie [„middle east respiratory syndrome“]). Die Tatsache, dass die SARS-CoV-2-Erkrankung („severe acute respiratory syndrome coronavirus 2“) auch ohne Symptome ansteckend ist, hat im Wesentlichen zu der raschen Ausbreitung und weltweiten Pandemie geführt. Eine Vielzahl von Viren, die auch eine Virämie induzieren können, wurde im Ejakulat nachgewiesen und wird damit mit einer etwaigen urogenitalen Infektion in Verbindung gebracht. Hierzu zählen u. a. das Mumps‑, Coxsackie-Viren oder Enteroviren. Es wurde auch gezeigt, dass auch eine Zika-Virusinfektion sexuell über die Spermien als Carrier übertragen werden kann. Somit spielen Viren auch eine wichtige Rolle in der Reproduktion. Bei der Nierentransplantation sind Urologen häufig mit viralen Infektionen konfrontiert. Die effektivste Waffe gegenüber Viren stellt die Impfprävention dar. Schlussfolgerung Äthiopathogenetisch ist der Urogenitaltrakt im Rahmen einer Virämie oder über eine Reaktivierung durch eine Immunsuppression am häufigsten mitbetroffen. Therapeutisch kommt der Immunmodulation sowie der Impfprophylaxe eine führende Rolle zu.
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28
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Duarte-Neto AN, Teixeira TA, Caldini EG, Kanamura CT, Gomes-Gouvêa MS, Dos Santos ABG, Monteiro RAA, Pinho JRR, Mauad T, da Silva LFF, Saldiva PHN, Dolhnikoff M, Leite KRM, Hallak J. Testicular pathology in fatal COVID-19: A descriptive autopsy study. Andrology 2021; 10:13-23. [PMID: 34196475 PMCID: PMC8444746 DOI: 10.1111/andr.13073] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Multi-organ damage is a common feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, going beyond the initially observed severe pneumonia. Evidence that the testis is also compromised is growing. OBJECTIVE To describe the pathological findings in testes from fatal cases of COVID-19, including the detection of viral particles and antigens, and inflammatory cell subsets. MATERIALS AND METHODS Postmortem testicular samples were obtained by percutaneous puncture from 11 deceased men and examined by reverse-transcription polymerase chain reaction (RT-PCR) for RNA detection and by light and electron microscopy (EM) for SARS-CoV-2. Immunohistochemistry (IHC) for the SARS-CoV-2 N-protein and lymphocytic and histiocytic markers was also performed. RESULTS Eight patients had mild interstitial orchitis, composed mainly of CD68+ and TCD8+ cells. Fibrin thrombi were detected in five cases. All cases presented congestion, interstitial edema, thickening of the tubular basal membrane, decreased Leydig and Sertoli cells with reduced spermatogenesis, and strong expression of vascular cell adhesion molecule (VCAM) in vessels. IHC detected SARS-Cov-2 antigen in Leydig cells, Sertoli cells, spermatogonia, and fibroblasts in all cases. EM detected viral particles in the cytoplasm of fibroblasts, endothelium, Sertoli and Leydig cells, spermatids, and epithelial cells of the rete testis in four cases, while RT-PCR detected SARS-CoV-2 RNA in three cases. DISCUSSION AND CONCLUSION The COVID-19-associated testicular lesion revealed a combination of orchitis, vascular changes, basal membrane thickening, Leydig and Sertoli cell scarcity, and reduced spermatogenesis associated with SARS-CoV-2 local infection that may impair hormonal function and fertility in men.
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Affiliation(s)
- Amaro N Duarte-Neto
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Instituto Adolfo Lutz, São Paulo, Brazil
| | - Thiago A Teixeira
- Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Elia G Caldini
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Michele S Gomes-Gouvêa
- Departamento de Gastroenterologia (LIM-07), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Angela B G Dos Santos
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Renata A A Monteiro
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - João R R Pinho
- Departamento de Gastroenterologia (LIM-07), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Thais Mauad
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz F F da Silva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Serviço de Verificação de Óbitos da Capital, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo H N Saldiva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marisa Dolhnikoff
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Katia R M Leite
- Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jorge Hallak
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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29
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Chandi A, Jain N. State of ART in the COVID-19 era and consequences on human reproductive system. Biol Reprod 2021; 105:808-821. [PMID: 34159367 DOI: 10.1093/biolre/ioab122] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 01/22/2023] Open
Abstract
The outbreak of the COVID-19 virus has created havoc on the socio-economic aspect of the world. With billions of lives affected by this wrecking pandemic, global fertility services were also not left untouched by its impact. The possibility of sexual transmission of SARS-CoV-2 virus, its impact on male and female fertility, pregnancy, its potential teratogenic effect, and handling of gametes in the clinical laboratories were major concerns among reproductive medicine specialists which led down all the reproductive health services including IUI, IVF/ICSI in most of the countries. Even the people did not intend to conceive during the pandemic crisis and were hesitant to avail such services. Discrete evidence regarding the pathophysiology of COVID-19 infection and its impact on the human reproductive system is not very clear. In this review article, we intend to incorporate all the evidence related to the COVID-19 infection and its impact on human reproduction available to date. It's our responsibility to provide rightful information and to keep our patients familiar with the existing lack of clear evidence. In this COVID-19 era, it's important that the fertility management be prioritized in sub-fertile couples with diminished fertility reserve, and high-risk conditions like malignancies, that may affect their long-term fertility prospects.
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Affiliation(s)
- Anadeep Chandi
- PGIMER, Chandigarh, H No 957, Sector 25, Panchkula, Haryana, India
| | - Neelam Jain
- Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Sector 32, Chandigarh, India
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