Male reproductive system inflammation after healing from coronavirus disease 2019

Morselli, Simone; Sebastianelli, Arcangelo; Liaci, Andrea; Zaccaro, Claudia; Pecoraro, Alessio; Nicoletti, Rossella; Manera, Alekseja; Bisegna, Claudio; Campi, Riccardo; Pollini, Simona; Antonelli, Alberto; Lagi, Filippo; Coppi, Marco; Baldi, Elisabetta; Marchiani, Sara; Nicolò, Sabrina; Torcia, Maria Gabriella; Annunziato, Francesco; Maggi, Mario; Vignozzi, Linda; Bartoloni, Alessandro; Rossolini, Gian María; Serni, Sergio; Gacci, Mauro

doi:10.1111/andr.13138

Cited by 16 publications

(20 citation statements)

References 31 publications

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“…Severe COVID-19 induce high serum levels of pro-inflammatory cytokines and in critical cases it induces the so-called “cytokine storm” with high likelihood of tissue damage [ 6 ]. Several studies have shown high levels of seminal pro- and anti-inflammatory cytokines [ 7 , 8 ] markers of apoptosis and impaired antioxidant activity along with compromised spermatogenesis in male patients recovering from COVID-19 [ 7 ], suggesting the presence of an inflammatory condition in the male genital tract. Dysregulated cytokines and chemokines may trigger an autoimmune reaction with consequent alteration of the testicular tissue [ 9 ]; TNF-α and IL-1β, in particular, may induce oxidative stress in the Sertoli cells and compromise the blood–testis barrier integrity [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Male reproductive health after 3 months from SARS-CoV-2 infection: a multicentric study

Paoli

Pallotti

Anzuini

et al. 2022

J Endocrinol Invest

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Purpose While SARS-CoV-2 infection appears not to be clinically evident in the testes, indirect inflammatory effects and fever may impair testicular function. To date, few long-term data of semen parameters impairment after recovery and comprehensive andrological evaluation of recovered patients has been published. The purpose of this study was to investigate whether SARS-CoV-2 infection affect male reproductive health. Methods Eighty patients were recruited three months after COVID-19 recovery. They performed physical examination, testicular ultrasound, semen analysis, sperm DNA integrity evaluation (TUNEL), anti-sperm antibodies (ASA) testing, sex hormone profile evaluation (Total testosterone, LH, FSH). In addition, all patients were administered International Index of Erectile Function questionnaire (IIEF-15). Sperm parameters were compared with two age-matched healthy pre-COVID-19 control groups of normozoospermic (CTR1) and primary infertile (CTR2) subjects. Results Median values of semen parameters from recovered SARS-CoV-2 subjects were within WHO 2010 fifth percentile. Mean percentage of sperm DNA fragmentation (%SDF) was 14.1 ± 7.0%. Gelatin Agglutination Test (GAT) was positive in 3.9% of blood serum samples, but no positive semen plasma sample was found. Only five subjects (6.2%) had total testosterone levels below the laboratory reference range. Mean bilateral testicular volume was 31.5 ± 9.6 ml. Erectile dysfunction was detected in 30% of subjects. Conclusion Our data remark that COVID-19 does not seem to cause direct damage to the testicular function, while indirect damage appears to be transient. It is possible to counsel infertile couples to postpone the research of parenthood or ART procedures around three months after recovery from the infection.

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Section: Introductionmentioning

confidence: 99%

Male reproductive health after 3 months from SARS-CoV-2 infection: a multicentric study

Paoli

Pallotti

Anzuini

et al. 2022

J Endocrinol Invest

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“…The COVID-19 pandemic has been associated with several health consequences pertaining to many bodily organs from the lungs to the brain, to others [ 1 , 2 ]. Even though it is well established that the COVID-19 vaccine is safe for reproduction [ 3 ], there have been a lot of theories pertaining to the fact that COVID-19 infection itself could impact male fertility [ 4 ]; however, data confirming this hypothesis are lacking.…”

Section: Introductionmentioning

confidence: 99%

A Case of Asthenozoospermia Following COVID-19 Infection

et al. 2022

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Purpose Studies pertaining to the effect of COVID-19 infection on male fertility are scarce. This case report describes a case of transient asthenozoospermia, absence of sperm motility, following a moderately severe COVID-19 infection. Case A couple presenting for infertility treatment due to low ovarian reserve presented for their second intrauterine insemination (IUI). Their first IUI was performed 1 month earlier when the semen parameters were normal. A couple of weeks before the second IUI, the unvaccinated 48-year-old male partner contracted COVID-19 and was admitted to the hospital for several days. He received IV Remdesivir and continuous oxygen by nasal cannula. His hospitalization did not require intubation or intensive care unit admission. He was discharged after 12 days of hospitalization without home oxygen treatment. On the day of the second IUI, the semen analysis showed a normal sperm count with 0% motility. Three months following his COVID-19 diagnosis, a repeat semen analysis showed restored normal parameters with more than 40% motility. Conclusion This aim of this report is to increase awareness that moderate COVID-19 requiring hospitalization could affect, though temporarily, sperm motility and should be considered in the differential diagnosis when male infertility is encountered.

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“…It is also possible that dysregulated cytokines and chemokines trigger an autoimmune reaction with consequences on testicular tissue [51], which may affect both semen quality (sperm concentration, motility) and the fertilizing ability of spermatozoa and the fusion of the gametes [52,53]. Several papers have investigated the levels of cytokines (both pro and anti-inflammatory) in COVID-19 recovering subjects, which have been shown to be deregulated, often coupled with the concomitant alterations of markers of apoptosis and oxidative stress [35,54]. SARS-CoV-2-related impairment of the gonadal hormone function with low Testosterone levels has also been observed [55][56][57].…”

Section: Indirect Damage To the Testes: Cytokines Inflammation And Fevermentioning

confidence: 99%

COVID-19 and its treatments: lights and shadows on testicular function

et al. 2022

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Purpose The SARS-CoV-2 pandemic has rapidly spread worldwide and, among the others, the male gender was quickly recognized as an independent risk factor for both the disease and its consequences. Since the possibility of long-term hormonal axis changes and male gamete impairment have been hypothesized but a relatively low levels of evidence has been reached, we focused this narrative mini-review on summarizing key state-of-the-art knowledge on male reproductive effects of COVID-19 as a quick reference for reproductive health specialists. Methods A comprehensive Medline/PubMed and Embase search was performed selecting all relevant, peer-reviewed papers in English published from 2020. Other relevant papers were selected from the reference lists. Results Available evidence indicates that the likelihood of direct testicular damage from SARS-CoV-2 is somewhat low, but there are many indirect ways (fever, cytokine imbalance, and drugs) through which the pituitary-gonadal axis and spermatogenesis may be disrupted. These alterations are probably transient, but as available evidence is low quality, it cannot be excluded that previous pathologies or comorbidities might modulate the risk of their persistence. On the other hand, available evidence shows high safety regarding andrological health for available vaccines, although studies are mainly focused on mRNA vaccines. Conclusion A careful andrological evaluation of men recovering from COVID-19 is highly recommended. Since available evidence is relatively scarce, a careful andrological follow-up and counseling of these patients are mandatory.

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Male reproductive system inflammation after healing from coronavirus disease 2019

Cited by 16 publications

References 31 publications

Male reproductive health after 3 months from SARS-CoV-2 infection: a multicentric study

Male reproductive health after 3 months from SARS-CoV-2 infection: a multicentric study

A Case of Asthenozoospermia Following COVID-19 Infection

COVID-19 and its treatments: lights and shadows on testicular function

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