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Fertil Steril No Evidence of Severe Acute Respiratory Syndrome-Coronavirus 2 in Semen of Males Recovering From Coronavirus Disease 2019

tetano

Editor, Senior Moderator
Fertil Steril


. 2020 Jun;113(6):1135-1139.
doi: 10.1016/j.fertnstert.2020.04.024. Epub 2020 Apr 17.
No Evidence of Severe Acute Respiratory Syndrome-Coronavirus 2 in Semen of Males Recovering From Coronavirus Disease 2019


Feng Pan[SUP] 1 [/SUP], Xingyuan Xiao[SUP] 1 [/SUP], Jingtao Guo[SUP] 2 [/SUP], Yarong Song[SUP] 1 [/SUP], Honggang Li[SUP] 3 [/SUP], Darshan P Patel[SUP] 4 [/SUP], Adam M Spivak[SUP] 5 [/SUP], Joseph P Alukal[SUP] 6 [/SUP], Xiaoping Zhang[SUP] 1 [/SUP], Chengliang Xiong[SUP] 7 [/SUP], Philip S Li[SUP] 8 [/SUP], James M Hotaling[SUP] 9 [/SUP]



Affiliations

Abstract

Objective: To describe detection of severe acute respiratory syndrome (SARS)-coronavirus 2 (CoV-2) in seminal fluid of patients recovering from coronavirus disease 2019 (COVID-19) and to describe the expression profile of angiotensin-converting enzyme 2 (ACE2) and Transmembrane Serine Protease 2 (TMPRSS2) within the testicle.
Design: Observational, cross-sectional study.
Setting: Tertiary referral center.
Patient(s): Thirty-four adult Chinese males diagnosed with COVID-19 through confirmatory quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) from pharyngeal swab samples.
Intervention(s): None.
Main outcome measure(s): Identification of SARS-CoV-2 on qRT-PCR of single ejaculated semen samples. Semen quality was not assessed. Expression patterns of ACE2 and TMPRSS2 in the human testis are explored through previously published single-cell transcriptome datasets.
Result(s): Six patients (19%) demonstrated scrotal discomfort suggestive of viral orchitis around the time of COVID-19 confirmation. Severe acute respiratory syndrome-CoV-2 was not detected in semen after a median of 31 days (interquartile range, 29-36 days) from COVID-19 diagnosis. Single-cell transcriptome analysis demonstrates sparse expression of ACE2 and TMPRSS2, with almost no overlapping gene expression.
Conclusion(s): Severe acute respiratory syndrome-CoV-2 was not detected in the semen of patients recovering from COVID-19 1 month after COVID-19 diagnosis. Angiotensin-converting enzyme 2-mediated viral entry of SARS-CoV-2 into target host cells is unlikely to occur within the human testicle based on ACE2 and TMPRSS2 expression. The long-term effects of SARS-CoV-2 on male reproductive function remain unknown.

Keywords: COVID-19; angiotensin-converting enzyme 2; coronavirus; infertility; male; semen.
 
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