COVID-19 Infection in the Human Reproductive Tract of Men and Nonpregnant Women

Morelli, Fabrício; Meirelles, Lyvia Eloiza de Freitas; Souza, Maria Vítoria Felipe de; Mari, Natália L.; Shinobu-Mesquita, Cristiane Suemi; Dartibale, Camila Buziquia; Damke, Gabrielle Marconi Zago Ferreira; Damke, Edílson; Silva, Vânia R. S. da; Souza, Raquel P.; Consolaro, Márcia Edilaine Lopes

doi:10.4269/ajtmh.20-1098

Cited by 15 publications

(15 citation statements)

References 96 publications

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“…In addition to lung cells, receptors are expressed in other types of cells, including the testis where both Leydig and Sertoli cells highly express ACE2 receptor (Wang and Xu 2020). Although co-expression of ACE2 and TMPRSS2 was found only in spermatogonia stem cells and spermatids, this observation suggested that viral infection could potentially harm the testes and compromise fertility status (Massarotti et al, 2021, Morelli et al, 2021.…”

Section: Introductionmentioning

confidence: 99%

Risk of contamination of semen, vaginal secretions, follicular fluid and ovarian medulla with SARS-CoV-2 in patients undergoing ART

et al. 2021

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STUDY QUESTION Can severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA be detected in the reproductive tract of asymptomatic patients undergoing ART? SUMMARY ANSWER SARS-CoV-2 mRNA is not detectable in semen, follicular fluid, vaginal secretions or residual medulla from ovarian tissue cryopreservation procedures in asymptomatic patients who undergo ART, irrespective of the results of a triage questionnaire and a nasopharyngeal SARS-CoV-2 RNA detection test. WHAT IS KNOWN ALREADY The SARS-CoV-2 pandemic had a huge impact on the activities of fertility clinics. Although some studies reported the presence of SARS-CoV-2 mRNA in the reproductive system during or after acute COVID-19 symptomatic infections, uncertainties remain regarding the presence of viral mRNA in the reproductive material and follicular fluid of asymptomatic patients undergoing ART. STUDY DESIGN, SIZE, DURATION An observational cohort trial of residual material samples including semen, follicular fluid, vaginal secretions and ovarian medulla was conducted during the second pandemic wave in Brussels from September 2020 to April 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS All patients who underwent ART (IUI, IVF/ICSI, oocyte and ovarian tissue cryopreservation) responded to a triage questionnaire at the beginning and end of the cycle and underwent nasopharyngeal swab collection for SARS-CoV-2 RNA detection by RT-PCR before the procedure according to standard recommendations. For semen analysis, only the questionnaire was requested the day before the sample collection. The ART cycles of patients with positive nasopharyngeal SARS-CoV-2 RNA detection tests and/or questionnaires were cancelled except for those that could not be postponed. After providing informed consent, swabs on residual materials were collected the day of the oocyte, ovarian tissue or semen collection and were processed for RT-qPCR. MAIN RESULTS AND THE ROLE OF CHANCE A total of 394 samples from 291 patients were analysed. Amongst them, 20 samples were obtained from patients with a positive questionnaire but negative nasopharyngeal SARS-CoV-2 test and 20 others were from patients with a positive nasopharyngeal SARS-CoV-2 test. The remaining samples were collected from patients with a negative or unknown nasopharyngeal SARS-CoV-2 test and/or a negative or unknown triage questionnaire. Viral RNA for SARS-CoV-2 was undetectable in all of the samples. LIMITATIONS, REASONS FOR CAUTION Considering the cancellation policy, only a limited number of samples from patients with positive triage questionnaires or nasopharyngeal SARS-CoV-2 tests were included in the analysis. WIDER IMPLICATIONS OF THE FINDINGS The study suggested that there was no risk of reproductive tract contamination by SARS-CoV-2 in asymptomatic patients, irrespective of the results from a triage questionnaire or nasopharyngeal SARS-CoV-2 test. The results suggested that no additional measures to prevent staff or cross-patient contamination need to be implemented in the IVF and andrology laboratories. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the Université Libre de Bruxelles and by a grant from Ferring. A.D. and I.D. received a grant from Ferring for the study. The authors have no other conflict of interest to declare related to this study. TRIAL REGISTRATION NUMBER N/A.

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Section: Introductionmentioning

confidence: 99%

Risk of contamination of semen, vaginal secretions, follicular fluid and ovarian medulla with SARS-CoV-2 in patients undergoing ART

et al. 2021

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“…Computed tomography-angiography (CT-A) showed acute thrombosis over atherosclerotic occlusive disease. The rest of the patients [11] had no clinical evidence of PAD. The occlusion was related to acute thrombosis of the arteries or distal embolization and confirmed by (CT-A).…”

Section: Acute Limb Ischemia As Part Of the Post Covid-19 Conditionsmentioning

confidence: 95%

“…The male sex is more affected in reproductive system, and one of the hypotheses for this is the higher amount of ACE 2 in the male gonads compared to the uterus [11,12] Musculoskeletal system occurrence of long-lasting arthralgia/myalgia Due to immobilization, they can lead to cachexia due to loss of muscle mass. Sarcopenia -impaired muscle function due to loss of muscle tissue [2,13] Ear Nose Throat pain and "noise" in the ears, throat irritation, loss of taste and smell(anosmia)…”

Section: Impaired Spermatogenesismentioning

confidence: 99%

Post COVID-19 Conditions and the Cardiovascular System

Симова¹,

Hristova²,

Tzanovska³

et al. 2021

Fighting the COVID-19 Pandemic

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One out of four patients affected by COVID-19 will experience persistent (>3-4 weeks) signs and symptoms (Post COVID-19 conditions or Post-Acute Sequelae of SARS-CoV-2 – PASC) and this fact will have a major significance for the healthcare and economic systems in the upcoming years. The cardiovascular system is one of the key targets for the Post COVID-19 syndrome, given the pathogenesis of the virus and prevalence of ACE-2 receptors. According to our initial personal experience via the campaign “Life after COVID” of the Bulgarian Cardiac Institute, a substantial proportion of patients having suffered from COVID-19 develop long-term cardiovascular consequences. They could range from rhythm disorder and blood pressure variation, through impairment of myocardial mechanics and heart failure, and to acute vascular manifestations of Post COVID-19 conditions, such as acute coronary syndrome, acute pulmonary embolism, and acute limb ischemia. These cardiovascular complications require special and dedicated medical attention, and we could share our personal experience on the matter.

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“…ACE2 and TMPRSS2 [10]. There are reports confirming the presence of ACE2 expression at ovary, uterus, vagina and placenta [9, 11–14]. In addition to this, expression of other receptors and proteases (BSG, CTSL, FURIN) has been demonstrated in male and female reproductive tissue by several studies by using single cell RNA sequencing approach and by analyzing publically available microarray datasets [4, 15].…”

Section: Introductionmentioning

confidence: 90%

Ovarian Granulosa Cells From Women With Pcos Express Low Levels of Sars-Cov-2 Receptors and Co-Factors

Naigaonkar

Patil

Joseph

et al. 2021

Preprint

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Purpose: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is global pandemic with more than 3 million deaths so far. Female reproductive tract organs express coronavirus-associated receptors and factors (SCARFs); suggesting they may be susceptible to SARS-CoV-2 infection however the susceptibility of ovary/follicle/oocyte to the same is still elusive. Co-morbidities like obesity, type-2 diabetes mellitus, cardiovascular disease etc. increase the risk of SARS-CoV-2 infection. These features are common in women with polycystic ovary syndrome (PCOS), warranting further scope to study SCARFs expression in ovary of these women. Materials and methods: SCARFs expression in ovary and ovarian tissues of women with PCOS and healthy women was explored by analyzing publically available microarray datasets. Transcript expression of SCARFs were investigated in mural and cumulus granulosa cells (MGCs and CGCs) from control and PCOS women undergoing in vitro fertilization (IVF). Results: Microarray data revealed that ovary expresses all genes necessary for SARS-CoV-2 infection. PCOS women mostly showed down-regulated/unchanged levels of SCARFs. MGCs and CGCs from PCOS women showed lower expression of receptors ACE2, BSG and DPP4 and protease CTSB than in controls. MGCs showed lower expression of protease CTSL in PCOS than in controls. Expression of TMPRSS2 was not detected in both cell types. Conclusions: Human ovarian follicle may be susceptible to SARS-CoV-2 infection. Lower expression of SCARFs in PCOS indicate that the risk of SARS-CoV-2 infection to the ovary may be lesser in these women than controls. This knowledge may help in safe practices at IVF settings in the current pandemic. Keywords: SARS-CoV-2, COVID-19, Ovarian granulosa cells, Oocyte, PCOS, IVF

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COVID-19 Infection in the Human Reproductive Tract of Men and Nonpregnant Women

Cited by 15 publications

References 96 publications

Risk of contamination of semen, vaginal secretions, follicular fluid and ovarian medulla with SARS-CoV-2 in patients undergoing ART

Risk of contamination of semen, vaginal secretions, follicular fluid and ovarian medulla with SARS-CoV-2 in patients undergoing ART

Post COVID-19 Conditions and the Cardiovascular System

Ovarian Granulosa Cells From Women With Pcos Express Low Levels of Sars-Cov-2 Receptors and Co-Factors

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