Andrological effects of SARS-Cov-2 infection: a systematic review and meta-analysis

Abstract

Purpose The short- and long-term andrological effects of coronavirus disease 2019 (COVID-19) have not been clarified. Our aim is to evaluate the available evidence regarding possible andrological consequences of COVID-19 either on seminal or hormonal parameters. The safety of the COVID-19 vaccines in terms of sperm quality was also investigated. Methods All prospective and retrospective observational studies reporting information on severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) mRNA semen and male genitalia tract detection (n = 19), as well as those reporting data on semen analysis (n = 5) and hormonal parameters (n = 11) in infected/recovered patients without any arbitrary restriction were included. Results Out of 204 retrieved articles, 35 were considered, including 2092 patients and 1138 controls with a mean age of 44.1 ± 12.6 years, and mean follow-up 24.3 ± 18.9 days. SARS-CoV-2 mRNA can be localized in male genitalia tracts during the acute phase of the disease. COVID-19 can result in short-term impaired sperm and T production. Available data cannot clarify long-term andrological effects. Low T observed in the acute phase of the disease is associated with an increased risk of being admitted to the Intensive Care Unit or death. The two available studies showed that the use of mRNA COVID-19 vaccines does not affect sperm quality. Conclusions The results of our analysis clearly suggest that each patient recovering from COVID-19 should be monitored to rule out sperm and T abnormalities. The specific contribution of reduced T levels during the acute phase of the infection needs to be better clarified.

Dynamic of Serum TWEAK Levels in Critically Ill COVID-19 Male Patients

“…Low levels of serum testosterone have been associated with endothelial dysfunction and inflammation and may also predispose men to less-effective immune response against infectious agents, such as COVID-19. Notably, data suggest that male hypogonadism may trigger a detrimental cytokine dysfunction, including high circulating levels of IL-6, TNF-alpha, and IL-1beta, thus portending poor outcomes in critically ill COVID19 patients [58][59][60][61]. It is also important to address that pro-inflammatory cytokines further dampen release and action of testosterone, thus initiating a vicious cycle [62].…”

Testosterone and Covid‐19: An update

“…SARS‐Cov‐2‐infected patients were characterised by reduced total testosterone levels (a), whereas no difference in either follicular stimulating hormone (FSH) levels (b) or luteinizing hormone (LH) levels (c) was observed. Figure reproduced with permission from Corona et al 45 …”

Cellular and Molecular Mechanisms of In Vivo and In Vitro SARS-CoV-2 Infection: A Lesson from Human Sperm

“…Despite this wide expression of SARS-CoV-2 receptors, the presence of the virus inside the sperm cells of infected men is still debated. While some authors did not detect the virus in human semen, either in the acute phase or the convalescent phase [ 13 , 14 , 15 , 16 ], other studies detected the virus in semen samples of patients with a high viral load during the acute or convalescent phase of infection [ 17 , 18 ].…”