Sperm quality and absence of SARS-CoV-2 RNA in semen after COVID-19 infection: a prospective, observational study and validation of the SpermCOVID test

Abstract

Objective To study the contagiousness of sperm and its influence on fertility after recovery from COVID-19 infection. Design Prospective cohort study. Setting University medical center. Patient(s) One hundred twenty Belgian men who had recovered from proven COVID-19 infection. Intervention(s) No intervention was performed. Main outcome measure(s) Sermm quality was assessed using the World Health Organisation criteria. DNA damage to sperm cells was assessed by quantifying the DNA fragmentation index and the high density stainability. Finally antibodies against SARS-CoV2 spike-1 antigen, nuclear and S1-receptor binding domain were measured by Elisa and chemilumenscent microparticle immunoassays, repsectively. Result(s) SARS-CoV-2 RNA was not detected in semen during the period shortly after infection nor at a later time. Mean progressive motility was reduced in 60% of men tested shortly (<1 month) after COVID-19 infection, 37% of men tested 1 to 2 months after COVID-19 infection, and 28% of men tested >2 months after COVID-19 infection. Mean sperm count was reduced in 37% of men tested shortly (<1 month) after COVID-19 infection, 29% of men tested 1 to 2 months after COVID-19 infection, and 6% of men tested >2 months after COVID-19 infection. The severity of COVID-19 infection and the presence of fever were not correlated with sperm characteristics, but there were strong correlations between sperm abnormalities and the titers of SARS-CoV-2 IgG antibody against spike 1 and the receptor- binding domain of spike 1, but not against nucleotide, in serum. High levels of antisperm antibodies developed in three men (2.5%). Conclusion(s) Semen is not infectious with SARS-CoV-2 at 1 week or more after COVID-19 infection (mean, 53 days). However, couples with a desire for pregnancy should be warned that sperm quality after COVID-19 infection can be suboptimal. The estimated recovery time is 3 months, but further follow-up studies are under way to confirm this and to determine if permanent damage occurred in a minority of men.

SARS-CoV-2 infects, replicates, elevates angiotensin II and activates immune cells in human testes

“…However, we did not evidence a strong correlation between fever and the development of testicular pathogenesis (Spearman’s = -0.195; p= 0.57). Recent data indicate that fever is not correlated with the sperm quality alteration after SARS-CoV-2 infection(16). The most prevalent comorbidities were systemic arterial hypertension (nine cases), diabetes mellitus (six cases), and obesity (six cases).…”

The COVID-19 pandemic — what have urologists learned?

“…Mean progressive sperm motility was reduced in 60%, 37% and 28% of men in the short, intermediate and long follow-up time groups, respectively, whereas mean sperm count was reduced in 37%, 29% and 6% of patients in the three groups, respectively 87 . The authors concluded that the estimated recovery time of sperm quality after COVID-19 infection is 3 months, but further follow-up studies are needed to determine whether a minority of men might suffer from permanent testicular damage 87 . The severity of COVID-19 infection (for example, the need to be hospitalized) and the presence of fever did not correlate with sperm characteristics in this study 87 .…”

“…In a prospective, observational study, sperm quality after recovery from COVID-19 was assessed using the WHO criteria. Sperm parameters were evaluated at three different time points after the infection: short (0–31 days, n = 35); intermediate (32–62 days, n = 51); and long (≥63 days, n = 34) 87 . Mean progressive sperm motility was reduced in 60%, 37% and 28% of men in the short, intermediate and long follow-up time groups, respectively, whereas mean sperm count was reduced in 37%, 29% and 6% of patients in the three groups, respectively 87 .…”

“…Sperm parameters were evaluated at three different time points after the infection: short (0–31 days, n = 35); intermediate (32–62 days, n = 51); and long (≥63 days, n = 34) 87 . Mean progressive sperm motility was reduced in 60%, 37% and 28% of men in the short, intermediate and long follow-up time groups, respectively, whereas mean sperm count was reduced in 37%, 29% and 6% of patients in the three groups, respectively 87 . The authors concluded that the estimated recovery time of sperm quality after COVID-19 infection is 3 months, but further follow-up studies are needed to determine whether a minority of men might suffer from permanent testicular damage 87 .…”

Persistence, prevalence, and polymorphism of sequelae after COVID-19 in young adults

“…Our findings are corroborated by other studies. Donders et al found sperm quality to be sub-optimal post COVID-19 disease with an estimated recovery time of 3 months (21). In addition, we found significant hyposomia (TDI <31) in those infected in the previous 6 months.…”