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Kloping YP, Hidayatullah F, Rahman ZA, Chung E, Hakim L. Male Reproductive Tract Involvement and Sperm Parameters in SARS-CoV-2 Patients: A Systematic Review and Meta-Analysis. World J Mens Health 2023; 41:538-557. [PMID: 36102101 PMCID: PMC10307665 DOI: 10.5534/wjmh.220019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 05/06/2022] [Accepted: 05/15/2022] [Indexed: 11/26/2023] Open
Abstract
PURPOSE There is a growing concern regarding the impact of SARS-CoV-2 infection on the male reproductive tract due to ACE2 receptor expression, however, its impact remains unclear. We performed this review to evaluate whether SARS-CoV-2 infection affects the male reproductive system. MATERIALS AND METHODS We conducted a search in the Embase, Scopus, and MEDLINE databases, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Eligible studies comprised articles reporting viral RNA presence in semen, sperm parameters, and orchitis or orchiepididymitis occurrence in SARS-CoV-2 patients. Observational studies' quality was determined using the Newcastle-Ottawa Scale (NOS). Case reports were assessed using the Joanna Briggs Institute (JBI)'s checklist. RESULTS A total of 32 relevant articles were included. Viral RNA was found in 7% of infected patients' semen (95% CI, -0.01 to 0.15) from 3 studies. There were also only 7% of patients with orchitis or orchiepididymitis clinical manifestations (95% CI, 0.05-0.10). The semen volume and concentration were 2.34 mL (95% CI, 1.87-2.81) and 51.73 million/mL (95% CI, 31.60-71.85). The progressive and total motility percentages were 36.11% (95% CI, 28.87-43.35) and 43.07% (95% CI, 28.57-57.57), respectively. The morphology was 6.03% (95% CI, -1.05 to 13.10). There is a difference in semen volume between moderate and severe infections (MD, 0.52; 95% CI, 0.27-0.76; p<0.0001) and concentration between mild and moderate (MD, 18.74; 95% CI, 1.02-36.46; p=0.04), mild and severe (MD, 43.50; 95% CI, 13.86-73.14; p=0.004), as well as moderate and severe (MD, 22.25; 95% CI, 9.33-35.17; p=0.0007). CONCLUSIONS SARS-CoV-2 infection may result in decreased sperm concentration in severe cases and the mechanism relates to potential reproductive tract inflammation. The absence of large viral RNA detection in the semen indicates a systemic effect, although this is largely unproven.
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Affiliation(s)
- Yudhistira Pradnyan Kloping
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Furqan Hidayatullah
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Zakaria Aulia Rahman
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Dr. Soetomo General-Academic Hospital, Surabaya, East Java, Indonesia
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Urology, Universitas Airlangga Teaching Hospital, Surabaya, East Java, Indonesia.
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Klepinowski T, Klepinowska M, Sagan L, Syrenicz A. Does SARS-CoV-2 Affect Human Semen? A Systematic Review and Meta-Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:669-677. [PMID: 36602657 PMCID: PMC9815676 DOI: 10.1007/s10508-022-02520-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 06/01/2023]
Abstract
Contradictory results have been reported regarding effects of the SARS-CoV-2 upon human semen. A timely and up-to-date systematic review with meta-analysis appears necessary. This study aimed to deliver pooled prevalence (PP) of SARS-CoV-2 in semen and pooled semen parameters as compared with the uninfected. The relevant databases were scanned by two authors for observational studies reporting analysis of semen in COVID-19 patients. The SARS-CoV-2-infected were assigned to group A (exposed arm), whereas the uninfected to group B (unexposed arm). Newcastle-Ottawa Scale was used to address the risk of bias. PRISMA guidelines were adopted. In case of homogenous studies, fixed-effects model was followed, whereas for heterogenous studies random-effects model was used. Of 990 studies, 24 were eligible involving 1589 subjects (947 in group A and 642 in group B). The "comparability" domain was biased the most. SARS-CoV-2 RNA was detected in three studies among 8 individuals producing the PP of 1.76% (95% CI 0.72-3.21). Sperm concentration was reduced significantly (WMD = -16.23 [95% CI -25.56 to -6.89], as well as total sperm in ejaculate (WMD = -34.84 [95% CI - 43.51 to -26.17]) and sperm volume (WMD = - 0.48 [95% CI - 0.59 to - 0.36] in group A as compared with controls. There was a non-significant effect upon progressive motility and leukocyte presence in semen. SARS-CoV-2 RNA in semen among the infected individuals is detected infrequently. By this token, sexual transmission through semen is of low probability and little concern for public health. However, significant decrease in sperm volume, sperm concentration, and total sperm in ejaculate has been noted. The current data, though, are limited, and more studies with longer follow-up are needed to evaluate the further impact.
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Affiliation(s)
- Tomasz Klepinowski
- Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, 71-252, Szczecin, Poland.
| | - Marta Klepinowska
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
| | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, 71-252, Szczecin, Poland
| | - Anhelli Syrenicz
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
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Al-Alami ZM, Albeitawi S, ALNatsheh MS, Albakri K, Qublan H, Muhaidat N, Abuhalaweh MA, AlRawashdeh MM, Alqam H. COVID-19 and Semen Fluid Parameters, a Retrospective Study from Infertility Clinics. Life (Basel) 2022; 12:life12122076. [PMID: 36556441 PMCID: PMC9781580 DOI: 10.3390/life12122076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
The study of the effects of SARS-CoV-2 infection and/or vaccination on semen fluid analysis (SFA) parameters is still incomplete. The aim of this study is to assess the effect of COVID-19 infection and vaccination on sperm parameters for a sample of individuals visiting multi-infertility clinics in Jordan. SFA records were collected retrospectively between September and November 2021 and analyzed using Jamovi software (version 2.2.5 for Windows); p-values < 0.05 were considered statistically significant. Sperm concentration, progressive motility, normal morphology, and semen liquefaction time, volume, and viscosity were compared among two data categories. In the first category of data, SFA records from 354 participants were separated into four groups: only vaccinated, infected and vaccinated, neither infected nor vaccinated, and only infected. In the other category, SFA from 49 subjects before their infection and/or vaccination and after were classified into the same mentioned groups and analyzed. There were no statistically significant differences between the studied parameters in the SFA records in the first data category and the second. Nevertheless, the sperm concentration was higher among vaccinated subjects compared to unvaccinated ones (p = 0.04). It is concluded that SARS-CoV-2 infection and vaccines have no negative effects on SFA parameters.
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Affiliation(s)
- Zina M. Al-Alami
- Medical Laboratory Sciences Department, Faculty of Allied Medical Sciences, Al-Ahliyya Amman University, Amman 19328, Jordan
- Correspondence:
| | - Soha Albeitawi
- Clinical Science Department, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan
| | - Maha S. ALNatsheh
- IVF Department, Al-Kindi Hospital, P.O. Box 851575, Amman 11185, Jordan
| | - Khaled Albakri
- Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan
| | - Hussein Qublan
- Irbid Specialty Hospital IVF Center, Irbid Specialty Hospital, Irbid 21110, Jordan
| | - Nadia Muhaidat
- Department of Obstetrics and Gynecology, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Mariam Ahmad Abuhalaweh
- Obstetrics and Gynecology Department, Al-Kindi Hospital, P.O. Box 851575, Amman 11185, Jordan
| | | | - Hiba Alqam
- Obstetrics and Gynecology Department, Islamic Hospital, Al-Abdali, King Hussein street, Amman 11942, Jordan
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Aksak T, Satar D, Bağci R, Gülteki̇n E, Coşkun A, Demi̇rdelen U. Investigation of the effect of COVID-19 on sperm count, motility, and morphology. J Med Virol 2022; 94:5201-5205. [PMID: 35778273 PMCID: PMC9349731 DOI: 10.1002/jmv.27971] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/17/2022] [Accepted: 06/29/2022] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a single-stranded RNA virus that causes many diseases such as respiratory diseases, cardiovascular diseases, and gastrointestinal diseases. Although it has been shown that the angiotensin-converting enzyme 2 receptor, which has a high affinity for the SARS-CoV-2 is mostly expressed in the lungs, it is also expressed especially in the cells of the testicular tissue. Although there are studies showing the effect of SARS-CoV-2 on spermatogenesis, the effects of COVID-19 on sperm count, motility, and morphology are still unclear. The aim of this study is to investigate changes in sperm quality in men who had recovered and never had COVID-19, therefore semen samples were analyzed from all individuals in the patient and control groups aged 20-50 years who agreed to participate in the study and voluntary in SBU Ministry of Health Adana City Training and Research Hospital. (Toros University Ethics Committee Decision Number: 1433, Date: April 15, 2021) (Adana Provincial Health Directorate Ethics Commission Decision dated May 27, 2021/5). Two groups were selected (100 men had and recovered from COVID-19, and 100 men never had COVID-19) spermiograms from both groups were analyzed in accordance with the World Health Organization standards. The sperm concentration of the COVID-19 negative group was significantly higher than those in the COVID-19 positive group. No statistically significant difference was detected between the groups for sperm motility and morphology. It was observed that men with COVID-19 had decreased sperm concentrations suggesting that COVID-19 may have a negative effect on male fertility. However, in the long term, more comprehensive studies with a large sample size are needed to understand better the changes in sperm concentration.
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Affiliation(s)
- Tiinçe Aksak
- Medical Laboratory TechniquesToros University Vocational School of Health ServicesMersinTurkey
| | - Deniz A. Satar
- Andrology LaboratoryAdana City Training and Research HospitalAdanaTurkey
| | - Rıdvan Bağci
- Andrology LaboratoryAdana City Training and Research HospitalAdanaTurkey
| | - Efdal O. Gülteki̇n
- Medical Laboratory TechniquesToros University Vocational School of Health ServicesMersinTurkey
| | - Arzu Coşkun
- Medical Laboratory TechniquesToros University Vocational School of Health ServicesMersinTurkey
| | - Umut Demi̇rdelen
- Andrology LaboratoryAdana City Training and Research HospitalAdanaTurkey
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Bechmann N, Maccio U, Kotb R, Dweik RA, Cherfane M, Moch H, Bornstein SR, Varga Z. COVID-19 Infections in Gonads: Consequences on Fertility? Horm Metab Res 2022; 54:549-555. [PMID: 35853464 PMCID: PMC9363149 DOI: 10.1055/a-1891-6621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/12/2022] [Indexed: 01/01/2023]
Abstract
COVID-19 may influence human fertility and sexuality in several ways. Different cell types in gonads show a constitutive expression of angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine subtype 2 (TMPRSS2), which provide potential entry pathways for SARS-CoV-2. In addition to the biological effects of a COVID-19 infection on the gonads, the impact of the ongoing COVID-19 pandemic on mental health issues and sexual behavior may affect reproduction. This review summarizes the current knowledge on the influence of COVID-19 on the gonads and discusses possible consequences on human fertility. In this context, the close interaction between the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-gonadal axis in response to COVID-19-related stress is discussed. Some women noticed changes in their menstrual cycle during the COVID-19 pandemic, which could be due to psychological stress, for example. In addition, occasional cases of reduced oocyte quality and ovarian function are described after COVID-19 infection. In men, COVID-19 may cause a short-term decrease in fertility by damaging testicular tissue and/or impairing spermatogenesis. Moreover, decreased ratio testosterone/LH and FSH/LH in COVID-19 compared to aged-matched healthy men has been reported. Available data do not suggest any effect of the available SARS-CoV-2 vaccines on fertility. The effects of long COVID on human fertility have been reported and include cases with premature ovarian failure and oligomenorrhoea in women and erectile dysfunction in men. Despite the increasing knowledge about the effects of COVID-19 infections on human gonads and fertility, the long-term consequences of the COVID-19 pandemic cannot yet be assessed in this context.
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Affiliation(s)
- Nicole Bechmann
- Institute of Clinical Chemistry and Laboratory Medicine, University
Hospital Carl Gustav Carus Dresden, Technische Universität Dresden,
Dresden, Germany
| | - Umberto Maccio
- Department of Pathology and Molecular Pathology, University Hospital
Zurich, Zurich, Switzerland
| | - Reham Kotb
- Department of Environmental and Public Health, College of Health
Science, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Rania Al Dweik
- Department of Environmental and Public Health, College of Health
Science, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Michele Cherfane
- Department of Environmental and Public Health, College of Health
Science, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Holger Moch
- Department of Pathology and Molecular Pathology, University Hospital
Zurich, Zurich, Switzerland
| | - Stefan R. Bornstein
- Department of Medicine III, University Hospital Carl Gustav Carus,
Medical Faculty Carl Gustav Carus, Technische Universität Dresden,
Dresden, Germany
- Department of Diabetes, School of Life Course Science and Medicine,
King's College London, London, UK
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital
Zurich, Zurich, Switzerland
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Boursier A, Dumont A, Boitrelle F, Prasivoravong J, Lefebvre-Khalil V, Robin G, Barbotin AL. Necrozoospermia: The tree that hides the forest. Andrology 2022; 10:642-659. [PMID: 35246969 DOI: 10.1111/andr.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Necrozoospermia is a condition found in 0.2 to 0.4 % of male infertility cases. The causes of necrozoospermia are multiple: they can be related to testicular and/or post-testicular damage. Additionally, these causes most often involve the production of reactive oxygen species (ROS) and/or sperm DNA fragmentation (SDF) which can reduce the chances of spontaneous pregnancy or affect the outcome of assisted reproductive technologies. OBJECTIVE To focus on potential etiologies of necrozoospermia, its diagnosis and its therapeutic management especially before the employment of ICSI. METHODS Authors searched PubMed/Medline, Web of Science, Cochrane Library, Google and Institutional websites for medical subheading terms and free text words referred to "necrozoospermia", "sperm vitality", "sperm viability", "sperm DNA fragmentation" and "ICSI". RESULTS We identified twelve main etiologies of necrozoospermia responsible for either a decrease of sperm vitality, a mild a moderate or a severe necrozoospermia. In case of a confirmed decreased vitality, a thorough check-up should be conducted and if available, etiological treatment should be proposed. Therapeutic management could also include repeated ejaculations, drug treatments, the use of ICSI with ejaculated or surgically extracted spermatozoa in case of a non-treatable necrozoospermia. DISCUSSION AND CONCLUSION The potential causes of necrozoospermia should be investigated because many of them could be corrected, thus avoiding the use of ICSI. Moreover, if ICSI procedure remains necessary, the therapeutic management of necrozoospermia could also improve the chances of success by reducing oxidative stress and/or sperm DNA fragmentation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Angele Boursier
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, CHU Lille, Lille, F-59000, France
| | - A Dumont
- Service de Gynécologie Endocrinienne et Médecine de La Reproduction, Assistance Médicale à La Procréation et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, CHU Lille, Lille, F-59000, France
| | - F Boitrelle
- Service de Biologie de la Reproduction et de Cytogénétique, Centre Hospitalier Poissy-Saint-Germain-en-Laye, Poissy, 78303, France
| | | | - V Lefebvre-Khalil
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, CHU Lille, Lille, F-59000, France
| | - Geoffroy Robin
- Service de Gynécologie Endocrinienne et Médecine de La Reproduction, Assistance Médicale à La Procréation et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, CHU Lille, Lille, F-59000, France.,Service d'Andrologie, Hôpital Huriez, CHU Lille, Lille, F-59000, France.,EA 4308 Gamètogenèse Et Qualité du Gamète, Université de Lille Et CHU de Lille, Lille, F-59000, France
| | - Anne-Laure Barbotin
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, CHU Lille, Lille, F-59000, France.,EA 4308 Gamètogenèse Et Qualité du Gamète, Université de Lille Et CHU de Lille, Lille, F-59000, France
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Sonkar C, Hase V, Banerjee D, Kumar A, Kumar R, Jha HC. Post COVID-19 Complications, Adjunct Therapy Explored, And Steroidal After Effects. CAN J CHEM 2022. [DOI: 10.1139/cjc-2021-0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For survivors of the COVID-19 disease, defeating the virus is just the beginning of a long road to recovery. The virus’s inducibility and catastrophic effects are distributed in multiple organs. The induction of cytokine storms in COVID-19 patients is due to the interaction of the SARS-CoV-2 virus and the host receptor, leading to various immunopathological consequences that might eventually lead to death. So far, it has hit tons of people across the world, but there is still no effective treatment. Patients facing the complications of COVID-19 after recovering have shown extensive clinical symptoms similar to previously circulating coronaviruses. Previous knowledge, and literature have opened up ways to treat this disease and manage post-COVID-19 complications, which poses a severe challenge to health system globally and may exacerbate the fragmentation of diseases. The use of steroids, as a treatment, showed various health problems and side-effects in COVID-19 patients. This review substantially discusses various post-COVID-19 complications observed, adjunctive therapies used along with common COVID-19treatment and spotlighted their side effects and consequences. This review provides latest literature on COVID-19 which emphasizes the subsequent complications in various organs, side-effects of drug, and alternative regimes that were used to treat COVID-19.
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Affiliation(s)
- Charu Sonkar
- Indian Institute of Technology Indore, 226957, Department of Biosciences and Biomedical Engineering, Indore, India, 452017
| | - Vaishnavi Hase
- Indian Institute of Technology Indore, 226957, Department of Biosciences and Biomedical Engineering, Indore, India
| | - Durba Banerjee
- School of Biotechnology (SOB), Greater Noida, Uttar Pradesh, India
| | - Awanish Kumar
- National Institute of Technology, 54702, Department of Biotechnology, Raipur, India
| | - Rajesh Kumar
- Indian Institute of Technology, 28692, Department of Physics, Dhanbad, India, 826004
| | - Hem C. Jha
- Indian Institute of Technology Indore, 226957, Department of Biosciences & Biomedical Engineering, Simrol-453552, Indore, India, 452017
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Kgatle MM, Lawal IO, Mashabela G, Boshomane TMG, Koatale PC, Mahasha PW, Ndlovu H, Vorster M, Rodrigues HG, Zeevaart JR, Gordon S, Moura-Alves P, Sathekge MM. COVID-19 Is a Multi-Organ Aggressor: Epigenetic and Clinical Marks. Front Immunol 2021; 12:752380. [PMID: 34691068 PMCID: PMC8531724 DOI: 10.3389/fimmu.2021.752380] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/21/2021] [Indexed: 12/19/2022] Open
Abstract
The progression of coronavirus disease 2019 (COVID-19), resulting from a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, may be influenced by both genetic and environmental factors. Several viruses hijack the host genome machinery for their own advantage and survival, and similar phenomena might occur upon SARS-CoV-2 infection. Severe cases of COVID-19 may be driven by metabolic and epigenetic driven mechanisms, including DNA methylation and histone/chromatin alterations. These epigenetic phenomena may respond to enhanced viral replication and mediate persistent long-term infection and clinical phenotypes associated with severe COVID-19 cases and fatalities. Understanding the epigenetic events involved, and their clinical significance, may provide novel insights valuable for the therapeutic control and management of the COVID-19 pandemic. This review highlights different epigenetic marks potentially associated with COVID-19 development, clinical manifestation, and progression.
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Affiliation(s)
- Mankgopo Magdeline Kgatle
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Ismaheel Opeyemi Lawal
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, Steve Biko Academic Hospital, Pretoria, South Africa
| | - Gabriel Mashabela
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DSI/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Tebatso Moshoeu Gillian Boshomane
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, Steve Biko Academic Hospital, Pretoria, South Africa
- Nuclear and Oncology Division, AXIM Medical (Pty), Midrand
| | - Palesa Caroline Koatale
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Phetole Walter Mahasha
- Precision Medicine and SAMRC Genomic Centre, Grants, Innovation, and Product Development (GIPD) Unit, South African Medical Research Council, Pretoria, South Africa
| | - Honest Ndlovu
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
| | - Hosana Gomes Rodrigues
- Laboratory of Nutrients and Tissue Repair, School of Applied Sciences, University of Campinas, Campinas, Brazil
| | - Jan Rijn Zeevaart
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- South African Nuclear Energy Corporation, Radiochemistry and NuMeRI PreClinical Imaging Facility, Mahikeng, South Africa
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Siamon Gordon
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Pedro Moura-Alves
- Ludwig Institute for Cancer Research, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Mike Machaba Sathekge
- Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DSI/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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9
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Montano L, Donato F, Bianco PM, Lettieri G, Guglielmino A, Motta O, Bonapace IM, Piscopo M. Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136846. [PMID: 34202243 PMCID: PMC8297116 DOI: 10.3390/ijerph18136846] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/11/2022]
Abstract
Several studies indicate that semen quality has strongly declined in the last decades worldwide. Air pollution represents a significant co-factor with the COVID-19 impact and has negative effects on the male reproductive system, through pro-oxidant, inflammatory and immune-dysregulating mechanisms. It has recently been reported that chronic exposure to PM2.5 causes overexpression of the alveolar ACE2 receptor, the entry route of SARS-CoV-2 into the organism shared by the lungs and testis where expression is highest in the body. In the testis, the ACE2/Ang-(1-7)/MasR pathway plays an important role in the regulation of spermatogenesis and an indirect mechanism of testicular damage could be due to the blockade of the ACE2 receptor by SARS-CoV-2. This prevents the conversion of specific angiotensins, and their excess causes inflammation with the overproduction of cytokines. PM2.5-induced overexpression of the alveolar ACE2 receptor, in turn, could increase local viral load in patients exposed to pollutants, producing ACE2 receptor depletion and compromising host defenses. By presenting an overall view of epidemiological data and molecular mechanisms, this manuscript aims to interpret the possible synergistic effects of both air pollution and COVID-19 on male reproductive function, warning that the spread of SARS-CoV-2 in the fertile years may represent a significant threat to global reproductive health. All of this should be of great concern, especially for men of the age of maximum reproductive capacity, and an important topic of debate for policy makers. Altered environmental conditions, together with the direct and indirect short- and long-term effects of viral infection could cause a worsening of semen quality with important consequences for male fertility, especially in those areas with higher environmental impact.
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Affiliation(s)
- Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL) Salerno, Coordination Unit of the Network for Environmental and Reproductive Health (EcoFoodFertility Project), “Oliveto Citra Hospital”, 84020 Oliveto Citra, Italy
- PhD Program in Evolutionary Biology and Ecology, Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
| | - Francesco Donato
- Unit of Hygiene, Epidemiology, and Public Health, Department of Medical and Surgical Specialties Radiological Sciences and Public Health, University of Brescia, 21100 Brescia, Italy;
| | - Pietro Massimiliano Bianco
- ISPRA, Italian Institute for Environmental Protection and Research, Via Vitaliano Brancati 60, 00144 Roma, Italy;
| | - Gennaro Lettieri
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
| | | | - Oriana Motta
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy;
| | - Ian Marc Bonapace
- Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
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10
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Erbay G, Sanli A, Turel H, Yavuz U, Erdogan A, Karabakan M, Yaris M, Gultekin MH. Short-term effects of COVID-19 on semen parameters: A multicenter study of 69 cases. Andrology 2021; 9:1060-1065. [PMID: 33851521 PMCID: PMC8251422 DOI: 10.1111/andr.13019] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 12/17/2022]
Abstract
Objective COVID‐19, which is known to be caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), is a global health problem that can cause multiorgan damage because of its use of the angiotensin‐converting enzyme 2 (ACE2) receptor in its pathophysiology. We aimed to investigate whether SARS‐CoV‐2 had a short‐term effect on spermatogenesis, which plays an important role in male reproductive health as it has abundant ACE2 expression in testicular tissue. Material and methods This multicenter study included 69 patients aged 20–45 years, who admitted to our hospitals between April 2020 and October 2020 with a history of a positive test result for SARS‐CoV‐2 based on the nasopharyngeal or oropharyngeal swab samples and had recovered from the disease at least three months earlier and who had undergone a spermiogram test in the hospital database within the last year before the onset of disease. The patients were divided into two groups according to their COVID‐19 symptoms being mild or moderate, depending on whether they had received home treatment or required hospitalization for oxygen therapy. Semen samples taken before and after COVID‐19 were compared within and between the groups in terms of sperm parameters. Results The mean age of the patients included in the study was 30.4±4.8 years in the mild symptomatic COVID‐19 group and 31.06±4.2 years in the moderate symptomatic group. When the spermiogram samples of the patients before and after COVID‐19 were evaluated, it was found that motility and vitality significantly decreased in the mild symptomatic group, while the decrease in all semen parameters was statistically significant in the moderate symptomatic group. Conclusion Although the mechanism by which COVID‐19 causes testicular involvement remains uncertain, its short‐term results on spermatogenesis reveals that COVID‐19 negatively affects sperm parameters.
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Affiliation(s)
- Guven Erbay
- Department of Urology, Karaman Training and Research Hospital, Karaman, Turkey
| | - Ahmet Sanli
- Department of Urology, Karaman Training and Research Hospital, Karaman, Turkey
| | - Harun Turel
- Department of Urology, Karaman Training and Research Hospital, Karaman, Turkey
| | - Ufuk Yavuz
- Department of Urology, Karaman Training and Research Hospital, Karaman, Turkey
| | - Abdullah Erdogan
- Department of Urology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | | | - Mehmet Yaris
- Urology, Diyarbakir Genesis Hospital, Diyarbakir, Turkey
| | - Mehmet Hamza Gultekin
- Department of Urology, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, Istanbul, Turkey
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