Radiological patterns of incidental epididymitis in mild‐to‐moderate COVID‐19 patients revealed by colour Doppler ultrasound

Abstract

The testis is a potential target organ for SARS‐CoV‐2 infection. Our study intended to investigate any testicular involvement in mild‐to‐moderate COVID‐19 men. We conduct a cross‐sectional study in 18 to 55‐year‐old men hospitalised for confirmed COVID‐19. A senior radiologist executed the ultrasound with multi‐frequency linear probe in all participants, regardless of any scrotal complaints. Exclusion criteria involved any situation that could impair testicular function. Statistical analysis compared independent groups, classified by any pathological change. Categorical and numerical outcome hypotheses were tested by Fisher's Exact and Mann–Whitney tests, using the Excel for Mac, version 16.29 (p < .05). The sample size was 26 men (mean 33.7 ± 6.2 years; range: 21–42 years), all without scrotal complaints. No orchitis was seen. Eleven men (32.6 ± 5.8 years) had epididymitis (42.3%), bilateral in 19.2%. More than half of men with epididymitis displayed epididymal head augmentation > 1.2 cm (p = .002). Two distinct epididymitis’ patterns were reported: (a) disseminated micro‐abscesses (n = 6) and (b) inhomogeneous echogenicity with reactional hydrocele (n = 5). Both patterns revealed increased epididymal head, augmented Doppler flow and scrotal skin thickening. The use of colour Doppler ultrasound in mild‐to‐moderate COVID‐19 men, even in the absence of testicular complaints, might be useful to diagnose epididymitis that could elicit fertility complications.

Effects of moderate COVID-19 infection on semen oxidative status and parameters 14 and 120 days after diagnosis

“…Because of the high similarity between the genomes of SARS-CoV and SARS-CoV-2 (Malik 2020), the new virus (SARS-CoV-2) may cause similar complications in testicular tissue (Madjunkov et al 2020). In a previous study, Carneiro et al (2021) evaluated testicular involvement in 26 patients with mild-to-moderate COVID-19 infection and reported that none of those patients had scrotal complaints and/or orchitis. However, a significant percentage of those individuals (42.3%) showed signs of epididymal inflammatory changes upon radiological examination.…”

COVID-19 Is a Multi-Organ Aggressor: Epigenetic and Clinical Marks

“…Renal damage in cases with no underlying renal conditions suggested SARS-CoV-2 as the underlying cause, and this was marked by abnormal blood work and increased levels of proteins in the urine. Lengthy hospitalisation stays, acute kidney injury (AKI), and increased mortality were the most common consequences of severe or critical cases of COVID-19 (107)(108)(109)(110)(111)(112)(113). COVID-19 causes severe physiologic and neurological stress, which may release increased stress hormone and alter testosterone levels.…”

Virusinfektionen in der Urologie

“…In Autopsiestudien konnten schwere zytopathologische Schäden in an COVID-19 verstorbenen Patienten beobachtet werden, die einhergingen mit Beeinträchtigungen der Spermatogenese in Abhängigkeit der entsprechenden ACE-2-Expression [ 13 ]. Interessanterweise ließen sich bei Patienten mit moderat bis schweren Verläufen sonographisch Zeichen einer inzidentellen Epididymitis feststellen, ohne dass dies klinisch manifest wurde [ 14 ]. Darüber hinaus wurden in COVID-19-Patienten pathologische Befunde in Spermiogrammen berichtet wie etwa eine Oligozoospermie, Leukospermie und eingeschränkte Motilität [ 13 ].…”