Effect of COVID-19 on male reproduction

There is a structural basis for invasion of the male reproductive system by the novel coronavirus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Current evidence suggests this virus can cause substantial damage to male testicles, leading to decreased testosterone levels, increased luteinizing hormone levels, and a decrease in sperm production and quality. Potential mechanisms for this damage include local inflammation of the testes, cytokine storms and fever. SARS-CoV-2 has strong transmissive ability, and its impact on the male reproductive system deserves attention. In view of the limited existing research, the aim of this study was to review the impact of the novel coronavirus on male reproduction and the potential mechanism.

SARS-CoV-2; Male reproductive system; Male fertility; COVID-19; Reproductive hormones; Damage mechanism

[1] Coronaviridae Study Group of the International Committee on Taxonomy of Viruses. The species severe acute respiratory syndromerelated coronavirus: classifying 2019-NcoV and naming it SARS-CoV-2. Nature Microbiol. 2020; 5: 536–544.

[2] Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, function and antigenicity of the SARS CoV-2 spike gycoprotein. Cell. 2020; 181: 281–292.e6.

[3] Khan R, Naseem T, Hussain MJ, Hussain MA, Malik SS. Possible potential outcomes from covid-19 complications on testes: lesson from SARS infection. Journal of the College of Physicians and Surgeons. 2020; 30: 118–120.

[4] Behnood S, Newlands F, O’Mahoney L, Haghighat Ghahfarokhi M, Muhid MZ, Dudley J, et al. Persistent symptoms are associated with long term effects of COVID-19 among children and young people: results from a systematic review and meta-analysis of controlled studies. PLOS ONE. 2023; 18: e0293600.

[5] Ma L, Xie W, Li D, Shi L, Ye G, Mao Y, et al. Evaluation of sex-related hormones and semen characteristics in reproductive-aged male COVID-19 patients. Journal of Medical Virology. 2021; 93: 456–462.

[6] Boboshko MY, Garbaruk ES, Vikhnina SM, Golovanova LE, Ogorodnikova EA. Speech intelligibility in adults after the new coronavirus infection (COVID-19). Vestn Otorinolaringol. 2023; 88: 15–21. (In Russian)

[7] Temiz MZ, Dincer MM, Hacibey I, Yazar RO, Celik C, Kucuk SH, et al. Investigation of SARS-CoV-2 in semen samples and the effects of COVID-19 on male sexual health by using semen analysis and serum male hormone profile: a cross-sectional, pilot study. Andrologia. 2021; 53: e13912.

[8] Rastrelli G, Di Stasi V, Inglese F, Beccaria M, Garuti M, Di Costanzo D, et al. Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients. Andrology. 2021; 9: 88–98.

[9] Arslan A, Sahbudak Bal Z, Erci E, Yıldırım Arslan S, Bilen NM, Avcu G, et al. SARS-CoV-2 reinfections in the pediatric cohort—a single-center experience. Journal of Tropical Pediatrics. 2023; 70: fmad049.

[10] Holtmann N, Edimiris P, Andree M, Doehmen C, Baston-Buest D, Adams O, et al. Assessment of SARS-CoV-2 in human semen-a cohort study. Fertil Steril. 2020; 114: 233–238.

[11] Mauro AK, Rengarajan A, Albright C, Boeldt DS. Fatty acids in normal and pathological pregnancies. Molecular and Cellular Endocrinology. 2022; 539: 111466.

[12] Adams AJ, Dohse N, Miller A, Tosti R. Pulmonary complications and mortality in patients with SARS-CoV-2 undergoing elective and emergent hand surgery. Journal of Hand and Microsurgery. 2023; 15: 371–375.

[13] Li X, Zhou Y, Jiang J, Long S, Dong G, Su M, et al. A retrospective study of long-term clinical outcomes in patients with chronic hepatitis C treated with interferon and ribavirin. Discovery Medicine. 2023; 35: 868–876.

[14] Bar-On L, Dekel H, Aftalion M, Chitlaru T, Erez N. Essential role for Batf3-dependent dendritic cells in regulating CD8 T-cell response during SARS-CoV-2 infection. PLOS ONE. 2023; 18: e0294176.

[15] Gertz A, Rader B, Sewalk K, Varrelman TJ, Smolinski M, Brownstein JS. Decreased seasonal influenza rates detected in a crowdsourced influenza-like illness surveillance system during the COVID-19 pandemic: prospective cohort study. JMIR Public Health and Surveillance. 2023; 9: e40216.

[16] Li J, Bai J, Xiang X, Guo Y, Yu H. Effect of COVID-19 on menstruation and lower reproductive tract health. International Journal of Women’s Health. 2023; 15: 1999–2013.

[17] Lin W, Wang Y, Chen Y. Efficacy analysis of physical therapy in treating chronic prostatitis: unblocking obstructed glandular ducts could be a novel treatment strategy. Research and Reports in Urology. 2023; 15: 553–561.

[18] Abedrabboh K, Al-Majid L, Al-Fagih Z, Al-Fagih L. Mechanism design for a fair and equitable approach to global vaccine distribution: the case of COVID-19. PLOS Glob Public Health. 2023; 3: e0001711.

[19] Schwarz S, Wang K, Yu W, Sun B, Schwarz W. Emodin inhibits current through SARS-associated coronavirus 3A protein. Antiviral Research. 2011; 90: 64–69.

[20] Namba M, Kaneda Y. Potential risk of overlooking biased reporting of vaccination against novel coronavirus disease 2019: lessons from Japan’s experience with the human papillomavirus vaccine. JMA Journal. 2023; 6: 513–514.

[21] Kłoda K, Mierzecki A, Mastalerz-Migas A, Babicki M. Beneficial effects of SARS-CoV-2 vaccination resulting from the COVID-19 pandemic with regard to the uptake of influenza virus, pneumococcal, and herpes zoster adult vaccination—a narrative literature review. Annals of Agricultural and Environmental Medicine. 2023; 30: 587–594.

[22] Cai Z, Liu B. Unraveling the relationship between ACTH and cortisol levels in COVID-19 infections: a meta-analysis. PLOS ONE. 2023; 18: e0296281.

[23] Bühler AH, Willmund GD. Deployment-related quarantining-a risk or resilience factor for German military service members? A prospective analysis during the third-fifth waves of COVID-19. Frontiers in Public Health. 2023; 11: 1267581.

[24] Attia YA, Farag MR, Al-Harthi MA, Bovera F, Alqurashi AD, Di Cerbo A, et al. Heat detoxification of Jatropha cucas meal and its effect on productive and reproductive performance of quail. Poultry Science. 2023; 102: 103072.

[25] Yu S, Yao F, Li F, Deng Z, Deng L. A Sjögren’s syndrome patient rapidly progressed to scleroderma renal crisis after COVID-19 infection. Rheumatology Advances in Practice. 2023; 8: rkad107.

[26] Falahieh FM, Zarabadipour M, Mirani M, Abdiyan M, Dinparvar M, Alizadeh H, et al. Effects of moderate COVID-19 infection on semen oxidative status and parameters 14 and 120 days after diagnosis. Reproduction, Fertility, and Development. 2021; 33: 683–690.