No evidence of SARS-CoV-2 in semen of males recovering from COVID-19

SARS-CoV-2 was not detected in semen of COVID-19 patients. ACE2-mediated viral entry of SARS-CoV-2 into target host cells is unlikely within the human testicle based on ACE2 and TMPRSS2 expression.

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Volume 113, Issue 6, Pages 1135–1139

Authors:

Feng Pan, M.D., Xingyuan Xiao, M.D., Jingtao Guo, Ph.D., Yarong Song, M.D., Honggang Li, M.D., Darshan P. Patel, M.D., Adam M. Spivak, M.D., Joseph, P. Alukal, M.D., Xiaoping Zhang, M.D., Chengliang Xiong, M.D., Philip S. Li, M.D., James M. Hotaling, M.D., M.S.

Abstract:

Objective: 

To describe detection of SARS-CoV-2 in seminal fluid of patients recovering from COVID-19 and describe the expression profile of ACE2 and TMPRSS2 within the testicle.

Design: 

Observational, cross-sectional study

Setting: 

Tertiary referral center

Patients: 

Thirty-four adult Chinese males diagnosed with COVID-19 through confirmatory quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) from pharyngeal swab samples

Intervention: 

None

Main Outcome Measures: 

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.

Results: 

Six patients (19%) demonstrated scrotal discomfort concerning for viral orchitis around the time of COVID-19 confirmation. SARS-CoV-2 was not detected in semen after a median of 31 days (IQR: 29-36 days) from COVID-19 diagnosis. Single-cell transcriptome analysis demonstrates sparse expression of ACE2 and TMPRSS2, with almost no overlapping gene expression.

Conclusions: 

SARS-CoV-2 was not detected in the semen of patients recovering from COVID19 one month after COVID-19 diagnosis. ACE2-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.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

2 Comments

Go to the profile of Firuza
Firuza 5 months ago

With the evolving nature of the SARS-CoV-2 virus and the paradigm shifts in the dynamics of the interactions between the virus and the host, we have witnessed a plethora of scientific articles in this field. One as yet less written aspect is the impact of this virus on the female and male Reproductive systems. In this paper, Pan et al looked at the semen samples of 34 Chinese men recovering from Covid-19, the median time from diagnosis to semen collection was 31 days (IQR:29-36 days). This time period was after the peaking of the symptoms. There is a possibilty that the virus could have stopped being secreted in the semen during this time. Hence it is difficult to establish the reason for the absence of the virus in the semen of these men at this point in time. More intriguing is the sparse expression of ACE2  and TMPRSS2 in the single cell transcriptome analysis within the testes. A history of intake of ACE inhibitors was not elicited in these men.

However a paper in the same month by Wang and Xu(1) validates the presence of the ACE2 receptors in the spermatogonia, Leydig and Sertoli cells by scRNA-seq Profiling in the human testes. Since the damaging impact of the virus is seen more in men than women it is worthwhile to explore the protective role of estrogen and progesterone in women. More studies however are required to understand whether there is a differntial impact of this virus on the two reproductive systems because of the way the ACE2 receptor presents to the virus.

References

1) Wang Z, Xu X. scRNA-seq Profiling of Human Testes Reveals the Presence of the ACE2 Receptor, a target for SARS-CoV-2 Infection in Spermatogonia, Leydig and Sertoli Cells. Cells April 2020; 2-9

Go to the profile of Cennikon Pakpahan
Cennikon Pakpahan 3 months ago

Let me introduce myself. I am a cennikon from Andrology Program at Airlangga University Indonesia. I want to ask in the method section. Is there any clear protocol that you use to avoid non-cement contamination during sample collection? please explain. thank you