Assessment of SARS-CoV-2 in human semen—a cohort study

Abstract

Objective: To investigate the presence of viral RNA in human semen of patients with severe acute-respiratory syndrome coronavirus 2 (SARS-CoV-2) and to evaluate its presence and relevance in semen parameters. Design: Pilot cohort study. Setting: University hospital. Patient(s): Thirty-four men were distributed as: 1) patients in convalescence (patients with confirmed SARS-CoV-2 infection in pharyngeal swab according to reverse-transcription polymerase chain reaction [RT-PCR] or antibodies); 2) negative control group (no antibodies); and 3) patients with an acute infection (detection of SARS-CoV-2 in pharyngeal swab). Intervention: Semen and a blood sample were collected from each individual. Main Outcome Measure(s): Analysis of semen quality according to the World Health Organization standards. Detection of SARS-CoV-2 by RT-PCR in the native semen sample and after density gradient preparation. Confirmation of immunoglobulin (Ig) A und IgG antibodies in the blood. Result(s): Eighteen semen samples from recovered men were obtained 8-54 days after absence of symptoms, 14 from control subjects, and 2 from patients with an active COVID-19 infection. No RNA was detected by means of RT-PCR in the semen, including semen samples from two patients with an acute COVID-19 infection. Subjects with a moderate infection showed an impairment of sperm quality. Conclusion(s):A mild COVID-19 infection is not likely to affect testis and epididymis function, whereas semen parameters did seem impaired after a moderate infection. SARS-CoV-2 RNA could not be detected in semen of recovered and acute COVID-19-positive men. This suggests no viral transmission during sexual contact and assisted reproductive techniques, although further data need to be obtained. (Fertil Steril Ò 2020;114:233-8. Ó2020 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

Investigation of SARS-CoV-2 in Semen of Patients in the Acute Stage of COVID-19 Infection

“…They have shown the absence of SARS-COV-2 in semen samples in 12 recovered patients and in the testes of one deceased patient during acute infection [17]. Similarly, Holtmann et al [18] reported absence of SARS-CoV-2 in the semen of 34 patients. Only 2 of them were in the acute stage.…”

Italian males recovering from mild COVID-19 show no evidence of SARS-CoV-2 in semen despite prolonged nasopharyngeal swab positivity

“…Recently, Angiotensin-converting enzyme 2 (ACE2), the receptor used by the virus to enter human cells, has been identified in human testis as it is highly expressed in Leydig, Sertoli, and seminiferous tubules cells, and new findings suggest a possible expression of ACE2 even in spermatocytes. At the time of this article, few studies looking for the presence of SARS-CoV-2 in human semen are available but have come to discordant conclusions [1][2][3][4][5]. In particular, while the detection of SARS-CoV-2 RNA in semen during the acute phase of severe symptomatic infections has already been demonstrated, weaker evidence has been shown of virus shedding through semen in the recovery phase or convalescence of COVID-19 and in patients with mild symptoms or in asymptomatic cases.…”

SARS-CoV-2 and Male Infertility: Possible Multifaceted Pathology

“…Interestingly, in-situ hybridization of testicular tissue specimens does not recognize viral genomic materials [8]. Moreover, studies could not yet find viral trace in the seminal plasma [9,10]. This indicates that inflammatory and immunologic reactions take pivotal role in the viral-mediated testicular damage.…”