Effects of Infection with SARS-CoV-2 on the Male and Female Reproductive Systems: A Review

Abstract

Coronavirus Disease-2019 (COVID-19) is a rapidly spreading pandemic that began at the end of 2019. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Reproductive health has always been one of the most important healthcare problems, and the impacts of COVID-19 on the reproductive systems have become an emerging topic. The effects of infection with SARS-CoV-2 on males are more harmful than on females. The outcomes of pregnancy also can show the condition of male and female reproductive system health. The vertical transmission of SARS-CoV-2 significantly affects pregnancy healthy. SARS-CoV-2, antibody, and other factors, such as the decline of lymphocyte counts, and increased erythrocyte sedimentation rate, C-reactive protein, and D-dimer levels, are evidence of SARS-CoV-2 vertical transmission. Angiotensin-converting enzyme 2 (ACE2) is regarded as a virus receptor in the reproductive system. The expression and activity of ACE2 are influenced by sex hormones, especially the male sex hormones. The strength of immunity is crucial to fighting off viral infection. Antibodies against SARS-CoV-2 show different expression in male and female patients, and the antibodies have been regarded as having potential applications in COVID-19 prevention and treatment. This review aims to present the current status of what is known about the involvement of the male and female reproductive systems, as well as the effects on pregnancy health, during infection with SARS-CoV-2, and discusses the implications for future fertility.

Prospective two‐arm study of the testicular function in patients with COVID‐19

“…Published reports are limited by small study groups, lack of the control group, and the absence of follow‐up examinations during recovery warranting further research and in‐depth exploration of the topic. 9 …”

“…There is ultimately too little information to draw reliable conclusions regarding the effects of the virus on male reproduction. Published reports are limited by small study groups, lack of the control group, and the absence of follow‐up examinations during recovery warranting further research and in‐depth exploration of the topic 9 …”

“…Published reports are limited by small study groups, lack of the control group, and the absence of follow-up examinations during recovery warranting further research and in-depth exploration of the topic. 9 The current prospective series is aimed at investigating the effect of SARS-CoV-2 on the testicular function and determining the extent of damage to testicular cells.…”

Long‐term side effects and lingering symptoms post COVID‐19 recovery

“…The outlier ratio of ALT/AST and gamma-glutamyl transferase continues to decline and was less than 10%. 25 Multivariant metabotyping study by Holmes et al 39 41 A meta-analysis on more than 3 million reported global cases conformed that male COVID-19 infected patients had 3 times the odds of requiring the intensive treatment unit admission and higher odds of death compared to women. 42 In a recent in vitro study, it was shown that 17β-estradiol can reduce SARS-CoV-2 infection, the group also showed that TMPRSS2 gene expression can be reduced by estrogen after SARS-Cov-2 infection, TMPRSS2 is involved in COVID-19 infectiveness capacity.…”

“…COVID‐19 was not just age bias but also sex bias towards severe disease. 41 A meta‐analysis on more than 3 million reported global cases conformed that male COVID‐19 infected patients had 3 times the odds of requiring the intensive treatment unit admission and higher odds of death compared to women. 42 …”