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Umakanthan S, Katwaroo AR, Bukelo M, Bg S, Boralingaiah P, Ranade AV, Rangan P, Shashidhar S, Kini JR, Kini G. Post-Acute Sequelae of Covid-19: A System-wise Approach on the Effects of Long-Covid-19. AMERICAN JOURNAL OF MEDICINE OPEN 2024; 12:100071. [PMID: 39268246 PMCID: PMC11387218 DOI: 10.1016/j.ajmo.2024.100071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/01/2024] [Indexed: 09/15/2024]
Abstract
The SARS-CoV-2 virus responsible for the COVID-19 pandemic has profoundly impacted global health, economics, and society. This review seeks to encompass an overview of current knowledge on COVID-19, including its transmission, pathogenesis, and clinical presentation related to various systems within the human body. COVID-19 is a highly contagious illness that has rapidly spread worldwide. As of August 4, 2023, the WHO reported over 570 million confirmed cases of COVID-19 and over 6.3 million deaths. Although the virus is most common in adults, children can also be infected. Respiratory droplets that are produced when an infected person coughs or sneezes are the primary transmission mode for COVID-19. Additionally, the virus can be disseminated via contact with contaminated surfaces or objects, as it can remain viable for several hours or days. SARS-CoV-2 is a respiratory virus that enters cells by bonding with the angiotensin-converting enzyme 2 (ACE2) receptor. Once inside the cell, the virus replicates and produces new particles that can infect other cells. Interestingly, the effects of post-acute sequelae of SARS-CoV-2 infection (PASC) encompass more than just respiratory system. The findings presented in the data suggest that PASC significantly impacts multiple organs and their respective physiological processes. In light of these observations, we aim to provide a detailed discussion of the relevant findings in this paper. Through our review, we hope to provide healthcare professionals with a deeper understanding of the effects of PASC on the human body, which could ultimately lead to improved patient outcomes and treatment strategies.
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Affiliation(s)
- Srikanth Umakanthan
- Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Arun Rabindra Katwaroo
- Trinidad Institute of Medical Technology, Department of Medicine, St. Augustine, Trinidad and Tobago
| | - Maryann Bukelo
- Department of Anatomical Pathology, Laboratory Services, North Central Regional Health Authority, Champ Fleurs, Trinidad and Tobago
| | - Shashidhar Bg
- Department of Critical care Medicine, Manipal Hospital, Bengaluru, India
| | - Prashanth Boralingaiah
- Early Psychosis Prevention and Intervention Center (EPPIC), Orygen Youth Health, Sunshine, Australia
| | - Anu V Ranade
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | | | - Jyoti Ramanath Kini
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
| | - Gayathri Kini
- Department of Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, India
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Marušić J, Hasković E, Mujezinović A, Đido V. Correlation of pre-existing comorbidities with disease severity in individuals infected with SARS-COV-2 virus. BMC Public Health 2024; 24:1053. [PMID: 38622590 PMCID: PMC11020189 DOI: 10.1186/s12889-024-18457-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
Shortly after the first publication on the new disease called Coronavirus Disease 2019 (Covid-19), studies on the causal consequences of this disease began to emerge, initially focusing only on transmission methods, and later on its consequences analyzed in terms of gender, age, and the presence of comorbidities. The aim of our research is to determine which comorbidities have the greatest negative impact on the worsening of the disease, namely which comorbidities indicate a predisposition to severe Covid-19, and to understand the gender and age representation of participants and comorbidities. The results of our study show that the dominant gender is male at 54.4% and the age of 65 and older. The most common comorbidities are arterial hypertension, diabetes mellitus, and cardiovascular diseases. The dominant group is recovered participants aged 65 and older, with comorbidities most frequently present in this group. The highest correlation between patients with different severity of the disease was found with cardiovascular diseases, while the coefficient is slightly lower for the relationship between patients with different disease severity and urinary system diseases and hypertension. According to the regression analysis results, we showed that urinary system diseases have the greatest negative impact on the worsening of Covid-19, with the tested coefficient b being statistically significant as it is 0.030 < 0.05. An increase in cardiovascular diseases affects the worsening of Covid-19, with the tested coefficient b being statistically significant as it is 0.030 < 0.05. When it comes to arterial hypertension, it has a small impact on the worsening of Covid-19, but its tested coefficient b is not statistically significant as it is 0.169 > 0.05. The same applies to diabetes mellitus, which also has a small impact on the worsening of Covid-19, but its tested coefficient b is not statistically significant as it is 0.336 > 0.05. Our study has shown that comorbidities such as urinary system diseases and cardiovascular diseases tend to have a negative impact on Covid-19, leading to a poor outcome resulting in death, while diabetes mellitus and hypertension have an impact but without statistical significance.
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Affiliation(s)
- Jasmina Marušić
- Department of Health Care, Faculty of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina.
- , Marjanovića put 39, 72000, Zenica, Bosnia and Herzegovina.
| | - Edhem Hasković
- Department of Biology, Faculty of Science, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Adnan Mujezinović
- Department of Health Care, Faculty of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina
| | - Vedran Đido
- Department of Public Health, Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Hallak J, Caldini EG, Teixeira TA, Correa MCM, Duarte-Neto AN, Zambrano F, Taubert A, Hermosilla C, Drevet JR, Dolhnikoff M, Sanchez R, Saldiva PHN. Transmission electron microscopy reveals the presence of SARS-CoV-2 in human spermatozoa associated with an ETosis-like response. Andrology 2024. [PMID: 38469742 DOI: 10.1111/andr.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/05/2024] [Accepted: 01/23/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Severe acute syndrome coronavirus 2 can invade a variety of tissues, including the testis. Even though this virus is scarcely found in human semen polymerase chain reaction tests, autopsy studies confirm the viral presence in all testicular cell types, including spermatozoa and spermatids. OBJECTIVE To investigate whether the severe acute syndrome coronavirus 2 is present inside the spermatozoa of negative polymerase chain reaction-infected men up to 3 months after hospital discharge. MATERIALS AND METHODS This cross-sectional study included 13 confirmed moderate-to-severe COVID-19 patients enrolled 30-90 days after the diagnosis. Semen samples were obtained and examined with real-time polymerase chain reaction for RNA detection and by transmission electron microscopy. RESULTS In moderate-to-severe clinical scenarios, we identified the severe acute syndrome coronavirus 2 inside spermatozoa in nine of 13 patients up to 90 days after discharge from the hospital. Moreover, some DNA-based extracellular traps were reported in all studied specimens. DISCUSSION AND CONCLUSION Although severe acute syndrome coronavirus 2 was not present in the infected men's semen, it was intracellularly present in the spermatozoa till 3 months after hospital discharge. The Electron microscopy (EM) findings also suggest that spermatozoa produce nuclear DNA-based extracellular traps, probably in a cell-free DNA-dependent manner, similar to those previously described in the systemic inflammatory response to COVID-19. In moderate-to-severe cases, the blood-testes barrier grants little defence against different pathogenic viruses, including the severe acute syndrome coronavirus 2. The virus could also use the epididymis as a post-testicular route to bind and fuse to the mature spermatozoon and possibly accomplish the reverse transcription of the single-stranded viral RNA into proviral DNA. These mechanisms can elicit extracellular cell-free DNA formation. The potential implications of our findings for assisted conception must be addressed, and the evolutionary history of DNA-based extracellular traps as preserved ammunition in animals' innate defence might improve our understanding of the severe acute syndrome coronavirus 2 pathophysiology in the testis and spermatozoa.
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Affiliation(s)
- Jorge Hallak
- Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Androscience, Science & Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory., Androscience Institute, Sao Paulo, Brasil
| | - Elia G Caldini
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Thiago A Teixeira
- Androscience, Science & Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory., Androscience Institute, Sao Paulo, Brasil
- Departamento de Cirurgia, Divisão de Urologia, Hospital Universitário da Universidade Federal do Amapá, Amapá, Brazil
| | | | - Amaro N Duarte-Neto
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Fabiola Zambrano
- Department of Preclinical Sciences, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Center of Translational Medicine-Scientific and Technological Bioresource Nucleus (CEMT-BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Anja Taubert
- Institute of Parasitology, Justus Liebig University Giessen, Giessen, Germany
| | - Carlos Hermosilla
- Institute of Parasitology, Justus Liebig University Giessen, Giessen, Germany
| | - Joël R Drevet
- GReD Institute, CNRS-INSERM-Université Clermont Auvergne, Faculty of Medicine, Clermont-Ferrand, France
| | - Marisa Dolhnikoff
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Raul Sanchez
- Center of Translational Medicine-Scientific and Technological Bioresource Nucleus (CEMT-BIOREN), Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
- Institute of Parasitology, Justus Liebig University Giessen, Giessen, Germany
| | - Paulo H N Saldiva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Neto FTL, Viana MC, Cariati F, Conforti A, Alviggi C, Esteves SC. Effect of environmental factors on seminal microbiome and impact on sperm quality. Front Endocrinol (Lausanne) 2024; 15:1348186. [PMID: 38455659 PMCID: PMC10918436 DOI: 10.3389/fendo.2024.1348186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/29/2024] [Indexed: 03/09/2024] Open
Abstract
Objective This review provides a comprehensive overview of the existing research on the seminal microbiome and its association with male infertility, while also highlighting areas that warrant further investigation. Methods A narrative review was conducted, encompassing all relevant studies published between 1980-2023 on the male reproductive tract microbiome in humans. This review considered studies utilizing culture-based, polymerase chain reaction (PCR)-based, and next-generation sequencing (NGS)-based methodologies to analyze the microbiome. Data extraction encompassed sample types (semen or testicular tissue), study designs, participant characteristics, employed techniques, and critical findings. Results We included 37 studies comprising 9,310 participants. Among these, 16 studies used culture-based methods, 16 utilized NGS, and five employed a combination of methods for microorganism identification. Notably, none of the studies assessed fungi or viruses. All NGS-based studies identified the presence of bacteria in all semen samples. Two notable characteristics of the seminal microbiome were observed: substantial variability in species composition among individuals and the formation of microbial communities with a dominant species. Studies examining the testicular microbiome revealed that the testicular compartment is not sterile. Interestingly, sexually active couples shared 56% of predominant genera, and among couples with positive cultures in both partners, 61% of them shared at least one genital pathogen. In couples with infertility of known causes, there was an overlap in bacterial composition between the seminal and vaginal microbiomes, featuring an increased prevalence of Staphylococcus and Streptococcus genera. Furthermore, the seminal microbiome had discernible effects on reproductive outcomes. However, bacteria in IVF culture media did not seem to impact pregnancy rates. Conclusion Existing literature underscores that various genera of bacteria colonize the male reproductive tract. These organisms do not exist independently; instead, they play a pivotal role in regulating functions and maintaining hemostasis. Future research should prioritize longitudinal and prospective studies and investigations into the influence of infertility causes and commonly prescribed medication to enhance our understanding of the seminal microbiota's role in reproductive health.
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Affiliation(s)
| | - Marina C. Viana
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil
| | - Federica Cariati
- Department of Public Health, University of Naples Federico II, Napoli, Italy
| | - Alessandro Conforti
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples, Federico II, Naples, Italy
| | - Carlo Alviggi
- Department of Public Health, University of Naples Federico II, Napoli, Italy
| | - Sandro C. Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil
- Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, Brazil
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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Frumer M, Aharony SM, Shoshany O, Kedar D, Baniel J, Golan S. Prostate-specific antigen level association with COVID-19 infection and vaccination. Clin Genitourin Cancer 2023; 21:e405-e411. [PMID: 37270370 PMCID: PMC10159928 DOI: 10.1016/j.clgc.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/29/2023] [Accepted: 05/01/2023] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The associations among SARS-CoV-2 infection, vaccination and total serum prostate serum antigen (PSA) levels in men undergoing screening for prostate cancer are unknown. METHODS A retrospective analysis of data from a large health maintenance organization. Records of individuals aged 50 to 75 years with two serum PSA tests taken between March 2018 and November 2021 were included. Individuals with prostate cancer were excluded. Changes in PSA levels were compared between individuals who had at least 1 SARS-CoV-2 vaccination and/or infection between the two PSA tests and individuals who did not have an infection and were not vaccinated between the two PSA tests. Subgroup analyses were performed to assess the impact of the elapsed time between the event and the second PSA test on the results. RESULTS The study and control groups included 6,733 (29%) and 16 286 (71%) individuals, respectively. Although the median time between PSA tests was shorter in the study vs. the control group (440 vs. 469 days, P<.001), PSA elevation between the tests was higher in the study group (0.04 vs. 0.02, P<.001). The relative risk for PSA elevation ≥1 ng/dL was 1.22 (95% CI 1.1, 1.35). Among individuals who were vaccinated, PSA increased by 0.03 ng/dL (IQR -0.12, 0.28) and 0.09 ng/dL (IQR -0.05, 0.34) after 1 and 3 doses, respectively (P<.001). Multivariate linear regression showed that SARS-CoV-2 events (β 0.043; 95% CI 0.026-0.06) were associated with a greater risk for PSA elevation, after adjusting for age, baseline PSA and days between PSA tests. CONCLUSION SARS-CoV-2 infection and vaccinations are associated with a slight increase in PSA, with the third anti-COVID vaccine dose having a more prominent impact, but its clinical significance is unknown yet. Any significant increase in PSA must be investigated and cannot be dismissed as secondary to SARS-CoV-2 infection or vaccination.
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Affiliation(s)
- Michael Frumer
- Department of Urology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Shachar Moshe Aharony
- Department of Urology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ohad Shoshany
- Department of Urology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Kedar
- Department of Urology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jack Baniel
- Department of Urology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shay Golan
- Department of Urology, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Andrade G, Iori I, Hsieh MK, Milani G, Zandoná PCE, Teixeira TA, Drevet JR, Costa EM, Hallak J. Serum lipid profile levels and semen quality: new insights and clinical perspectives for male infertility and men's health. Int Urol Nephrol 2023; 55:2397-2404. [PMID: 37442905 DOI: 10.1007/s11255-023-03688-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023]
Abstract
PURPOSE Several clinical scenarios regulate the final ejaculated semen, which is pivotal to reproductive success. Sperm motility and plasma membrane fusogenic activity primarily rely on the peculiar sperm lipid composition, influenced by the patient's metabolism, genetics, nutritional, environmental status, and concomitant clinical entities such as varicocele. This study aimed to determine the relationship between serum lipid profile and testicular function (semen quality and testosterone levels). METHODS This retrospective study uses medical charts of 278 infertile men who attended andrological care between 2000 and 2019. Seminal analysis data, lipid profile, and total serum testosterone were collected. A multiple linear regression analysis was performed to evaluate the influence of the lipid parameters on the seminal variables. Statistical analyses were carried out with p ≤ 0.05 considered statistically significant. RESULTS Seminal creatine kinase activity (p = 0.024) is negatively related to HDL (p = 0.032) and triglycerides (p = 0.037), while total testosterone (p < 0.0001) and seminal volume (p = 0.046) appeared both to be negatively related to triglycerides (p = 0.030 and p = 0.033, respectively). CONCLUSION Medical advice commonly advocated to prevent endothelial dysfunction and cardiovascular disease and improve HDL-cholesterol and triglyceride levels in dyslipidemic patients should also be given to infertile men. Physicians should give patients a thorough assessment, including the blood lipid profile, hormonal status, and routine seminal examinations. We propose a more comprehensive men´s health check-up for the infertile male population, not limited to a simple evaluation of basic sperm parameters.
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Affiliation(s)
- Gustavo Andrade
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Ivan Iori
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Mariana K Hsieh
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Faculdade Israelita de Ciências da Saúde Albert Einstein School of Medicine, Sao Paulo, Brazil
| | - Giovanna Milani
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
| | - Pedro C E Zandoná
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil
| | - Thiago A Teixeira
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil
- Division of Urology, Federal University of Amapa, University Hospital, Macapa, Brazil
| | - Joël R Drevet
- Faculty of Medicine, GReD Institute, CNRS-INSERM-Université Clermont Auvergne, CRBC Building, Clermont-Ferrand, France
| | - Elaine Maria Costa
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil
- Division of Endocrinology, University of Sao Paulo, Sao Paulo, Brazil
| | - Jorge Hallak
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.
- Men's Health Study Group, Institute for Advanced Studies, Sao Paulo, Brazil.
- Division of Urology, Department of Surgery, University of Sao Paulo, Sao Paulo, Brazil.
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil.
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Kervancioglu Demirci E, Dursun M, Seviç E, Ergül RB, Önel M, Ağaçfidan A, Kadıoğlu A. Evidence for residual SARS-CoV-2 in corpus cavernosum of patients who recovered from COVID-19 infection. Andrology 2023; 11:1016-1022. [PMID: 36426580 DOI: 10.1111/andr.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 is an ongoing health problem with millions of cases and deaths worldwide. Although the virus is transmitted with droplets through the respiratory system, the involvement of different organs has been reported. OBJECTIVES The pandemic caused urological procedures to be postponed when patient is infected with SARS-CoV-2. However, the reliability of 1 month postpone period and long-term complications of the virus, such as a possible erectile dysfunction (ED) is not clarified. We aimed to compare the corpus cavernosum of patients 1 and 7 months after COVID-19 infection with control patients who had not COVID-19 and search for SARS-CoV-2 in tissues using immunohistochemistry and electron microscopy. MATERIALS AND METHODS Three groups of subjects underwent penile prosthesis implantation and Nesbit procedure for Peyronie's disease 1 and 7 months after COVID-19 infection and control group without previous COVID-19 infection. We searched for SARS-CoV-2 in penile tissue using RT-PCR, electron microscopy and immunohistochemistry. RESULTS Electron microscopy and immunohistochemical staining showed SARS CoV-2 virus in the penile corpus cavernosum of patients 1 month after COVID-19 recovery. Immunohistochemical staining intensity correlated with the severity of previous infection. Transmission electron microscopy revealed intracellular virtual particles of about 80 nm with a typical morphology of prominent spikes and electron-dense dots of nucleocapsid in addition to vesicles filled with virus-like particles. Cells showed increased membrane trafficking. The 1 month after COVID-19 group showed an increased number of fibroblasts. The 7 months after COVID-19 group had similar morphology and immunoreactivity as control group. DISCUSSION This is the first study of late post-COVID examination of penis and the second study of early post-COVID examination of corpus cavernosum. For 1 month post-COVID patients, the aetiology of ED could be the viral infection that is also affecting corpora cavernosa. We hypothesize that viral infection affects the endocytic and exocytic pathways, hence the metabolic activity of cells that can be the reason of altered functions in some post-COVID patients. CONCLUSION This study is important because it did not detect any virus residue in the tissue samples at the seventh month. In addition, we can say that the penile surgeries should be postponed more than 1 month after the COVID infection according to this study. But, there is a need for new studies with large series and high levels of evidence that can show how long the virus remains in the corpus cavernosum. Patients should be followed in this respect.
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Affiliation(s)
- Elif Kervancioglu Demirci
- Department of Histology and Embryology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Dursun
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erva Seviç
- Department of Histology and Embryology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Rıfat Burak Ergül
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Önel
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Ağaçfidan
- Department of Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ateş Kadıoğlu
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Yu F, He H, Huang T, Zhou Y. Study on the cytokines related to SARS-Cov-2 in testicular cells and the interaction network between cells based on scRNA-seq data. Open Life Sci 2023; 18:20220661. [PMID: 37589002 PMCID: PMC10426268 DOI: 10.1515/biol-2022-0661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/04/2023] [Accepted: 06/23/2023] [Indexed: 08/18/2023] Open
Abstract
Inflammatory cytokine storms (CS) in COVID-19 patients are associated with elevated levels of 13 specific cytokines, potentially impacting male fertility by causing testicular cell damage and disrupting the immune microenvironment. Some patients present with scrotal discomfort and orchitis. However, few studies have explored cytokine expression in testicular cells and their role in cell-to-cell communication. In this study, we integrated single-cell sequencing data sets of testicular cells, annotating 20 cell clusters using marker genes and the Human Cell Landscape database. We constructed cell pseudo-chronological trajectories, hub genes, and analyzed the cytokine interaction network between sperm cells using CellChat. Our findings identified 12 types of testicular cells, with four cytokines (IL8, CCL2, CCL3, and TNF) potentially involved in immune processes. Pseudo-chronological trajectory analysis indicated IL8 and CCL3's essential roles in testicular macrophages and endothelial cell development, affecting the immune microenvironment. We determined eight key cytokines (IL1, IL2, IL4, IL6, CCL, CSF3, TNF, and IFN-II) functions in cell interaction networks. Network analysis of exogenous cytokines directly acting on testicular cells showed IL2 potentially affecting all testicular cells, suggesting a vital role in cell communication. This research offers valuable insights into CSs effects on testicular cells and their potential impact on male fertility during COVID-19 infection.
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Affiliation(s)
- Fan Yu
- Center of Clinical Laboratory Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, 518000, China
| | - Haihong He
- Center of Clinical Laboratory Medicine, Shenzhen Hospital, Southern Medical University, No. 1333
Xinhu Road, Shenzhen, Guangdong, 518000, China
| | - Tingting Huang
- Center of Clinical Laboratory Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, 518000, China
| | - Yiwen Zhou
- Center of Clinical Laboratory Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, 518000, China
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Viegas Madrid V, Peláez Laderas A, Soriano JB, Girón Moreno R, Marcos MC, Sánchez Ramírez A, Bermúdez JA, Olivier Gómez C, López-Fando Lavalle L. Genitourinary tract symptoms in patients admitted with COVID-19: Exploring changes in frequency by determinants and pandemic waves. CONTINENCE (AMSTERDAM, NETHERLANDS) 2023; 5:100572. [PMID: 36589696 PMCID: PMC9793955 DOI: 10.1016/j.cont.2022.100572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Urothelial cells exhibit increased expression of angiotensin-converting enzyme-2 receptor, which is the binding site of severe acute respiratory syndrome coronavirus 2 to cells. The frequency and distribution of genitourinary tract symptoms in patients diagnosed with coronavirus disease 2019 (COVID-19) is unknown. Objective We explored trends in genitourinary tract symptoms by gender and each of six pandemic waves in patients admitted for COVID-19, and related them with severity, death and length of hospitalization. Design Setting and Participants A retrospective study took place in our institution of COVID-19 admitted patients. Only patients with RT-PCR or antigen test confirmed SARS-CoV-2 infection were included. Demographic, clinical, and genitourinary symptoms were explored. Outcome Measurements and Statistical Analysis COVID-19 patients with genitourinary tract symptoms were compared with those without. Statistical comparisons were conducted by parametric and nonparametric tests for quantitative variables, and χ 2 test for qualitative variables. Results and limitations Out of a total of 4,661 COVID-19 patients, genitourinary symptoms were found in 21,1%. These symptoms were more frequent in patients admitted for longer than 30 days, except for urinary incontinence (UI) and erectile dysfunction (ED). Acute kidney injury (AKI) and urinary tract infections (UTI) had a higher presence in the 5th (16.7%; 12.8% respectively) and 3rd wave (13.3%; 12.6% respectively). Genitourinary symptoms were higher for those patients admitted in critical care units. Frequency of AKI, UI, UTI and acute urinary retention (AUR) were higher for patients who were finally deceased (26.2%; 3.5%; 13.6% and 3.6% respectively). Conclusions A high frequency of genitourinary symptoms in patients admitted for COVID-19 was observed, whose frequency and distribution varied according to pandemic waves. Specific genitourinary conditions were associated with worse outcomes and poorer prognosis.
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Affiliation(s)
| | | | - Joan B. Soriano
- Hospital Universitario La Princesa, Pneumology, Madrid, Spain
| | | | | | | | | | | | - Luis López-Fando Lavalle
- Hospital Universitario La Princesa, Urology, Madrid, Spain,Correspondence to: Servicio de Urología. Hospital La Princesa. Calle Diego de León 62. 28006, Madrid
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10
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Chen F, Hao L, Zheng K, Zhu S, Dai Z, Shi W, Wang X, Li X, Yang X, Zhao Q. Potential influence of COVID-19 and dexamethasone on the reproductive system: what we know and can expect. HUM FERTIL 2022:1-12. [DOI: 10.1080/14647273.2022.2142919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Fei Chen
- Department of Physiology, Jining Medical University, Jining, China
| | - Lanting Hao
- Department of Physiology, Jining Medical University, Jining, China
| | - Kai Zheng
- Department of Physiology, Jining Medical University, Jining, China
| | - Shiheng Zhu
- Department of Physiology, Jining Medical University, Jining, China
| | - Zhiqing Dai
- Department of Physiology, Jining Medical University, Jining, China
| | - Wenhao Shi
- Department of Physiology, Jining Medical University, Jining, China
| | - Xinyi Wang
- Department of Physiology, Jining Medical University, Jining, China
| | - Xinya Li
- Department of Physiology, Jining Medical University, Jining, China
| | - Xinyuan Yang
- Department of Physiology, Jining Medical University, Jining, China
| | - Qian Zhao
- Department of Physiology, Jining Medical University, Jining, China
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11
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Potential Similarities in Sex Difference in Key Genes and Their Expression, Network, EQTL and Pathways between COVID-19 and Chronic Kidney Disease Based on Mouse Model. J Pers Med 2022; 12:jpm12071190. [PMID: 35887687 PMCID: PMC9323909 DOI: 10.3390/jpm12071190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
COVID-19 and chronic kidney disease (CKD) share similarity in sex bias and key genes in the disease pathway of sex difference. We investigated the sex difference of molecular pathways of four key players of these two diseases using an existing large set of whole genome expression profiles from the kidneys of female and male mouse models. Our data show that there is little to no correlation at the whole genome expression level between female and male mice among these four genes. There are considerable sex differences among genes in upstream regulation, Ace2 complex interaction, and downstream pathways. Snap25 and Plcb4 may play important roles in the regulation of the expression level of Adam17, Tmprss2, and Cd146 in females. In males, Adh4 is a candidate gene for the regulation of Adam17, while Asl, Auts2, and Rabger1 are candidates for Tmprss2. Within the Ace2 complex, Cd146 directly influences the expression level of Adam17 and Ace2 in the female, while in the male Adam potentially has a stronger influence on Ace2 than that of Tmprss2. Among the top 100 most related genes, only one or two genes from four key genes and 11 from the control B-Actin were found to be the same between sexes. Among the top 10 sets of genes in the downstream pathway of Ace2, only two sets are the same between the sexes. We concluded that these known key genes and novel genes in CKD may play significant roles in the sex difference in the CKD and COVID-19 disease pathways.
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12
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Lucio Carrasco CH, Noda P, Barbosa AP, Vieira Borges da Silva EK, Gasque Bomfim C, Ventura Fernandes BH, Teixeira TA, Nunes Duarte Neto A, Nascimento Saldiva PH, Achoa Filho K, Rodrigues Guzzo C, Durigon EL, Affonso Fonseca FL, Corazzini R, Fanelli C, Noronha IL, Hallak J. SARS-CoV-2 Nucleocapsid Protein is Associated With Lower Testosterone Levels: An Experimental Study. Front Physiol 2022; 13:867444. [PMID: 35721551 PMCID: PMC9204174 DOI: 10.3389/fphys.2022.867444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
The ongoing COVID-19 pandemic represents an extra burden in the majority of public and private health systems worldwide beyond the most pessimistic expectations, driving an urgent rush to develop effective vaccines and effective medical treatments against the SARS-CoV-2 pandemic. The Nucleocapsid structural viral protein is remarkably immunogenic and hugely expressed during infection. High IgG antibodies against Nucleocapsid protein (N protein) levels were detected in the serum of COVID-19 patients, confirming its pivotal antigen role for a T lymphocyte response in a vaccine microenvironment. Currently, adverse events associated with immunizations have raised some degree of concern, irrespective of its huge benefits in dealing with disease severity and decreasing mortality and morbidity. This hitherto study evaluates histological changes in rats’ testes, epididymis, prostate, and seminal vesicles and analyzes hormone levels after solely N protein inoculation. Therefore, we exposed a group of Lewis rats to weekly injections of the recombinant N protein for 28 days, while a control group was inoculated with a buffer solution. The N group revealed a more significant number of spermatozoa. Spermatozoa in the seminiferous tubules were counted in twenty 400 × microscopy fields (mean of 9.2 vs. 4.6 in the control group; p < 0,01), but significantly lower testosterone levels (mean of 125.70 ng/dl vs. 309,00 ng/dl in the control group; p < 0,05) were found. No other histological and biochemical changes were displayed. Conclusively, these data suggest testicular hormonal imbalance mediated by the SARS-CoV-2 N protein that could be linked to reported post-COVID-19 syndrome hypogonadism. More relevant research might be performed to confirm this viral antigen’s deleterious mechanism in the human testicular microenvironment, particular in Leydig cell function.
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Affiliation(s)
- Caio Henrique Lucio Carrasco
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Hospital Das Clinicas, University of Sao Paulo Medical School, Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
| | - Paloma Noda
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ana Paula Barbosa
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Camila Gasque Bomfim
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Thiago Afonso Teixeira
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Hospital Das Clinicas, University of Sao Paulo Medical School, Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
| | - Amaro Nunes Duarte Neto
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
| | - Paulo Hilario Nascimento Saldiva
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
- Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
| | - Kamal Achoa Filho
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Cristiane Rodrigues Guzzo
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Edison Luiz Durigon
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - Roseli Corazzini
- Department of Clinical Laboratory, University Center of ABC Medical School, Santo Andre, Brazil
| | - Camilla Fanelli
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Irene Lourdes Noronha
- Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jorge Hallak
- Androscience—Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil
- Division of Urology, Hospital Das Clinicas, University of Sao Paulo Medical School, Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo Medical School, São Paulo, Brazil
- Institute of Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
- *Correspondence: Jorge Hallak,
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13
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Enikeev D, Taratkin M, Morozov A, Petov V, Korolev D, Shpikina A, Spivak L, Kharlamova S, Shchedrina I, Mestnikov O, Fiev D, Ganzha T, Geladze M, Mambetova A, Kogan E, Zharkov N, Demyashkin G, Shariat SF, Glybochko P. Prospective two‐arm study of testicular function in patients with COVID‐19. Andrology 2022; 10:1047-1056. [PMID: 35124885 PMCID: PMC9111462 DOI: 10.1111/andr.13159] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/26/2022] [Accepted: 01/26/2022] [Indexed: 12/01/2022]
Abstract
Background The COVID‐19 pandemic has led the international community to conduct extensive research into potential negative effects of the disease on multiple organs and systems in the human body. One of the most discussed areas is potential of the virus to compromise the testicular function. However, the lack of prospective studies on this topic makes it impossible to draw reliable conclusions on whether the disease affects the male reproductive system and, if so, to what extent. Objectives The current trial is aimed at investigating the effect of SARS‐CoV‐2 on the testicular function, hormone levels and determining the extent of impact on spermatogenesis and damage to testicular tissue. Materials and methods This prospective study included healthy controls and cases of patients suffering from viral pneumonia based on chest computed tomography (CT) and a positive SARS‐CoV‐2 throat swab exhibited moderate symptoms (World Health Organization (WHO) classification). Epidemiological, clinical, laboratory and ultrasound data were collected. A semen analysis was performed in cases during their hospital stay and 3 months after the discharge home. We also assessed the testicles obtained during autopsies of patients who died of COVID‐19 (n = 20). Results A total of 88 participants were included (44 controls and 44 cases). Blood testosterone levels were significantly decreased in 27.3% of the cases (12/44). The mean level (7.3±2.7 nmol/L) was lower than that in the healthy controls (13.5±5.2 nmol/L, p < 0.001). An increase in luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) was also detected compared to the healthy controls (p = 0.04 and p = 0.002). The semen analysis revealed decreased motility in COVID‐19 patients (p = 0.001), and a higher number of immobile sperm (during COVID‐19: 58.8% and at 3 months 47.4%, p = 0.005). All parameters returned to normal at 3 months after discharge. Direct mixed agglutination reaction (MAR) test at 3 months showed an increase of Ig A (p = 0.03). In the majority of autopsies (18/20), structural disorders of the testicular tissue, with signs of damage to germ cells were observed. Discussion and conclusion COVID‐19 and its management strategies significantly affect male hormone levels and sperm quality at the onset of the disease. Postmortem examination of testicular tissue confirmed inflammation and viral infiltration of the testicles. However, in patients with moderate to severe disease, the studied parameters of the testicular function returned to normal values within 3 months.
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Affiliation(s)
- Dmitry Enikeev
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Andrey Morozov
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Vladislav Petov
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Dmitry Korolev
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Anastasia Shpikina
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Leonid Spivak
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | | | | | | | - Dmitry Fiev
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | - Timur Ganzha
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
| | | | | | - Evgenia Kogan
- Department of Pathology Sechenov University Moscow Russia
| | | | | | - Shahrokh F. Shariat
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
- Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
- Department of Urology Weill Cornell Medical College New York New York USA
- Department of Urology University of Texas Southwestern Dallas Texas USA
| | - Petr Glybochko
- Institute for Urology and Reproductive Health Sechenov University Moscow Russia
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14
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Collins AB, Zhao L, Zhu Z, Givens NT, Bai Q, Wakefield MR, Fang Y. Impact of COVID-19 on male fertility. Urology 2022; 164:33-39. [PMID: 35007621 PMCID: PMC8741337 DOI: 10.1016/j.urology.2021.12.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/10/2021] [Accepted: 12/28/2021] [Indexed: 12/15/2022]
Abstract
COVID-19, the clinical condition caused by the SARS-CoV-2 virus, has been associated with massive cytokine storm and damage to multiple organ systems. Although evidence for the detection of SARS-CoV-2 virus in the testis remains scarce, testicular damage and dysregulation of gonadotropins associated with inflammation has been reported. Additionally, as a result of the rapidly evolving pandemic, frequently updated medical interventions and public policies leading to delays of care can play a role in fertility. This narrative review aims to summarize the current literature on how COVID-19 may influence male fertility.
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Affiliation(s)
- Alexander B Collins
- Department of Microbiology, Immunology & Pathology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, USA
| | - Lei Zhao
- Department of Respiratory Medicine, the 2nd People's Hospital of Hefei and Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Ziwen Zhu
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO, USA
| | - Nathan T Givens
- Department of Microbiology, Immunology & Pathology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, USA
| | - Qian Bai
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO, USA
| | - Mark R Wakefield
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO, USA
| | - Yujiang Fang
- Department of Microbiology, Immunology & Pathology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, USA; Department of Surgery, University of Missouri School of Medicine, Columbia, MO, USA..
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15
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Delaroche L, Bertine M, Oger P, Descamps D, Damond F, Genauzeau E, Meicler P, Le Hingrat Q, Lamazou F, Gschwind R, Ruppé E, Visseaux B. Evaluation of SARS-CoV-2 in semen, seminal plasma, and spermatozoa pellet of COVID-19 patients in the acute stage of infection. PLoS One 2021; 16:e0260187. [PMID: 34905541 PMCID: PMC8670700 DOI: 10.1371/journal.pone.0260187] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 11/03/2021] [Indexed: 02/06/2023] Open
Abstract
To date, there is limited information about the presence of SARS-CoV-2 in semen especially in the acute phase of the infection. While available data from cohort studies including a total of 342 patients in the acute or recovery phase of the infection are reassuring, one study mentioned detecting virus in the semen of 6/38 COVID-19 patients. Here we assessed SARS-CoV-2 presence in the semen of COVID-19 positive patients in the acute stage of infection, within 24 hours of the positive nasopharyngeal swabs. Semen, seminal plasma and spermatozoa pellet were screened for SARS-CoV-2 and manual or airborne contamination during semen sampling. Among the 32 COVID-19 volunteers, the median interval from the onset of symptoms to semen collection was 4 days [IQR: 0-8]. Only one presented positive SARS-CoV-2 PCR in semen and seminal plasma fractions, although the spermatozoa pellet was negative. Viral cultures were all negative. We observed slightly higher concentrations of bacterial DNA in the SARS-CoV-2 positive specimen than in all negative samples. The bacteria identified neither confirm nor rule out contamination by oropharyngeal secretions during collection. SARS-CoV-2 was rarely present in semen during the acute phase of the disease. This very rare situation could be connected to oral or manual contamination during semen collection. The possible presence of SARS-CoV-2 in semen calls for nasopharyngeal viral testing and strict hygiene protocols during semen collection before assisted reproductive attempts.
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Affiliation(s)
- Lucie Delaroche
- Ramsay Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, Le Chesnay, France
- Centre de Biologie Médicale, Hôpital Privé de Parly 2, Le Chesnay, France
- * E-mail:
| | - Mélanie Bertine
- Université de Paris, INSERM, IAME, Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - Pierre Oger
- Ramsay Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, Le Chesnay, France
| | - Diane Descamps
- Université de Paris, INSERM, IAME, Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - Florence Damond
- Université de Paris, INSERM, IAME, Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - Emmanuel Genauzeau
- Ramsay Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, Le Chesnay, France
- Centre de Biologie Médicale, Hôpital Privé de Parly 2, Le Chesnay, France
| | - Philippe Meicler
- Ramsay Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, Le Chesnay, France
| | - Quentin Le Hingrat
- Université de Paris, INSERM, IAME, Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
| | - Frédéric Lamazou
- Ramsay Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, Le Chesnay, France
| | | | - Etienne Ruppé
- Université de Paris, INSERM, IAME, Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Bactériologie, Paris, France
| | - Benoit Visseaux
- Université de Paris, INSERM, IAME, Paris, France
- AP-HP, Hôpital Bichat, Laboratoire de Virologie, Paris, France
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16
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Banihani SA. Human semen quality as affected by SARS-CoV-2 infection: An up-to-date review. Andrologia 2021; 54:e14295. [PMID: 34716614 PMCID: PMC8646253 DOI: 10.1111/and.14295] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/09/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022] Open
Abstract
Revealing the effect of SARS‐CoV‐2 infection on semen quality is a dynamic priority for many healthcare providers in the field as well as subfertile patients. Therefore, the collective summary in this research approach is still highly needed, especially with the continuous increase in original publications. Here, we provide an up‐to‐date review and discussion to collectively reveal the effect of SARS‐CoV‐2 infection on human semen quality. To do this, we reviewed all articles and abstracts published in Scopus and PubMed using the keywords ‘SARS‐CoV‐2’ and ‘COVID’ versus ‘sperm’ and ‘semen’. In summary, it can be revealed that, at both symptomatic and recovery stages of infection, no investigational evidence of SARS‐CoV‐2 shedding in human semen. Also, the mainstream of the up‐to‐date published work reveals a negative impact of SARS‐CoV‐2 infection on semen quality parameters, particularly sperm count and motility. However, long‐term post‐recovery comparative studies seem very important in this particular setting.
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Affiliation(s)
- Saleem Ali Banihani
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
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17
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Henkel R. Long-term consequences of sexually transmitted infections on men's sexual function: A systematic review. Arab J Urol 2021; 19:411-418. [PMID: 34552793 PMCID: PMC8451632 DOI: 10.1080/2090598x.2021.1942414] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: To systematically review the available literature on the long-term effects of sexually transmitted diseases (STIs) on male reproductive functions. Methods: A PubMed search was conducted on 3 January 2021, and as a result, 952 articles were retrieved. Exclusion of irrelevant articles resulted in 36 articles, dating from 1998 to 2020, which were analysed. Results: Only 52.8% of these articles described original research, while the rest were reviews. The majority (26) of the articles dealt with bacterial infections, of which 20 described Chlamydia trachomatis. There were 11 articles that described research on viruses, with five on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The analysis of the articles showed further that not much new knowledge on the long-term effects on male reproductive functions has been added. The existing knowledge that ascending infections can cause epididymo-orchitis, prostatitis or urethritis was confirmed. Due to epithelial inflammatory responses these infections can result in scarring with resulting infertility due to obstruction. These effects were described for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium or Treponema pallidum, as well as for the Zika and SARS-CoV-2 viruses. Even trichomoniasis can lead to long-term compromised male fertility if not treated. Conclusion: In conclusion, problem awareness needs to be raised and more research on this important topic needs to be conducted.
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Affiliation(s)
- Ralf Henkel
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.,Department of Urology, LogixX Pharma, Theale, Reading, UK.,American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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18
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Falahieh FM, Zarabadipour M, Mirani M, Abdiyan M, Dinparvar M, Alizadeh H, Paktinat S, Hosseinirad H. Effects of moderate COVID-19 infection on semen oxidative status and parameters 14 and 120 days after diagnosis. Reprod Fertil Dev 2021; 33:683-690. [PMID: 34324827 DOI: 10.1071/rd21153] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/03/2021] [Indexed: 12/27/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus causing coronavirus disease 2019 (COVID-19). Because COVID-19 is a multisystem infection, there are some concerns regarding its possible effects on male fertility. This study aimed to investigate the effects of COVID-19 on semen oxidative status and parameters 14 and 120 days after diagnosis in patients presenting with moderate infection (defined as respiratory symptoms, with or without fever, with Spo2 <93% and >90% and lung involvement <50%). Semen samples were obtained from 20 participants at two time points: the first sample on Day 14 and the second on Day 120 after diagnosis. Semen parameters (sperm concentration, motility, morphology, and viability) were evaluated, as were levels of seminal reactive oxygen species (ROS), malondialdehyde (MDA), total antioxidant capacity (TAC) and sperm DNA fragmentation. Semen parameters, including sperm motility and DNA integrity, improved at 120 days after the COVID-19 diagnosis relative to values at 14 days. In addition, ROS and MDA levels were significantly reduced in patients 120 days after infection, and TAC increased at 120 days compared with 14 days (during the acute stage of infection). In conclusion, the present study shows that the detrimental effects of COVID-19 on sperm properties caused by oxidative stress decrease up to Day 120 after diagnosis.
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Affiliation(s)
| | - Mahsa Zarabadipour
- Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Maryam Mirani
- Department of Reproductive Biology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Milad Abdiyan
- Department of Biotechnology, Faculty of Chemistry, University of Kashan, Kashan, Iran
| | - Marziyeh Dinparvar
- Department of Medical Laboratory Sciences, Faculty of Paramedical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Hamideh Alizadeh
- Department of Internal Medicine, Imam Khomeini University Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Shahrokh Paktinat
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hosseinirad
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and Corresponding author.
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19
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Duarte-Neto AN, Teixeira TA, Caldini EG, Kanamura CT, Gomes-Gouvêa MS, Dos Santos ABG, Monteiro RAA, Pinho JRR, Mauad T, da Silva LFF, Saldiva PHN, Dolhnikoff M, Leite KRM, Hallak J. Testicular pathology in fatal COVID-19: A descriptive autopsy study. Andrology 2021; 10:13-23. [PMID: 34196475 PMCID: PMC8444746 DOI: 10.1111/andr.13073] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Multi-organ damage is a common feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, going beyond the initially observed severe pneumonia. Evidence that the testis is also compromised is growing. OBJECTIVE To describe the pathological findings in testes from fatal cases of COVID-19, including the detection of viral particles and antigens, and inflammatory cell subsets. MATERIALS AND METHODS Postmortem testicular samples were obtained by percutaneous puncture from 11 deceased men and examined by reverse-transcription polymerase chain reaction (RT-PCR) for RNA detection and by light and electron microscopy (EM) for SARS-CoV-2. Immunohistochemistry (IHC) for the SARS-CoV-2 N-protein and lymphocytic and histiocytic markers was also performed. RESULTS Eight patients had mild interstitial orchitis, composed mainly of CD68+ and TCD8+ cells. Fibrin thrombi were detected in five cases. All cases presented congestion, interstitial edema, thickening of the tubular basal membrane, decreased Leydig and Sertoli cells with reduced spermatogenesis, and strong expression of vascular cell adhesion molecule (VCAM) in vessels. IHC detected SARS-Cov-2 antigen in Leydig cells, Sertoli cells, spermatogonia, and fibroblasts in all cases. EM detected viral particles in the cytoplasm of fibroblasts, endothelium, Sertoli and Leydig cells, spermatids, and epithelial cells of the rete testis in four cases, while RT-PCR detected SARS-CoV-2 RNA in three cases. DISCUSSION AND CONCLUSION The COVID-19-associated testicular lesion revealed a combination of orchitis, vascular changes, basal membrane thickening, Leydig and Sertoli cell scarcity, and reduced spermatogenesis associated with SARS-CoV-2 local infection that may impair hormonal function and fertility in men.
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Affiliation(s)
- Amaro N Duarte-Neto
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Instituto Adolfo Lutz, São Paulo, Brazil
| | - Thiago A Teixeira
- Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Elia G Caldini
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Michele S Gomes-Gouvêa
- Departamento de Gastroenterologia (LIM-07), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Angela B G Dos Santos
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Renata A A Monteiro
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - João R R Pinho
- Departamento de Gastroenterologia (LIM-07), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Thais Mauad
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Luiz F F da Silva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Serviço de Verificação de Óbitos da Capital, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo H N Saldiva
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marisa Dolhnikoff
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Katia R M Leite
- Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jorge Hallak
- Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Departamento de Cirurgia, Disciplina de Urologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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20
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Moshrefi M, Ghasemi-Esmailabad S, Ali J, Findikli N, Mangoli E, Khalili MA. The probable destructive mechanisms behind COVID-19 on male reproduction system and fertility. J Assist Reprod Genet 2021; 38:1691-1708. [PMID: 33977466 PMCID: PMC8112744 DOI: 10.1007/s10815-021-02097-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 01/28/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE The present study aims to summarize the current understanding of probable mechanisms and claims of adverse effects of SARS-CoV-2 on male fertility potential. METHODS Our search was including original articles, reviews, guidelines, letters to the editor, comments on guidelines, and editorials, regarding the male reproductive system. We used the words SARS-CoV-2, coronavirus, severe acute respiratory syndrome coronavirus 2, "2019 ncov," testis, sperm, male factor infertility, fertility treatment, semen, assisted reproductive technology (ART), sexual transmission, and ACE2. RESULTS Data showed coronavirus affects men more than women because of more expression of 2019 nCoV receptors (ACE2 and TMPRSS2) in testicular cells. Also, "Bioinformatics Analysis" suggests that sperm production may be damaged, since "Pseudo Time Analysis" has shown disruption in spermatogenesis. "Gene Ontology" (GO) showed an increase in viral reproduction and a decrease in sperm production-related terms. Recently, SARS-COV-2 mRNA and protein were detected in the semen of patients that had recovered from SARS-CoV-2 infection. Therefore, the probable disruption of blood-testis barrier (BTB) in febrile diseases is suspected in the acute phase of the disease enabling viral entry into the testes. Not only is spermatogenesis disturbed, but also disturbs gonadotropin, androgens, and testosterone secretion during SARS-CoV-2 infection. No sexual transmission has been reported yet; however, detection of the virus in semen still makes the sexual transmission an open question. CONCLUSION There is a concern that male fertility may be disturbed after the SARS-CoV-2 infection. Therefore, follow-up of the reproductive functions and male fertility may be necessary in recovered cases, especially in aged men.
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Affiliation(s)
- Mojgan Moshrefi
- Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Medical Nanotechnology & Tissue Engineering Research Center, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Jaffar Ali
- Synbios Media, www.synbiosmedia.com, P.O. Box 02042, GPO, Shah Alam, Selangor Malaysia
| | - Necati Findikli
- Bahceci Fulya Assisted Reproduction Center, Istanbul, Turkey
- Department of Bioengineering, Beykent University, Istanbul, Turkey
| | - Esmat Mangoli
- Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ali Khalili
- Research and Clinical Center for Infertility, Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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21
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Sharma AP, Sahoo S, Goyal K, Chandna A, Kirubanandhan S, Sharma V, Grover S, Singh MP, Bhalla A, Singh SK. Absence of SARS-CoV-2 infection in the semen of men recovering from COVID-19 infection: An exploratory study and review of literature. Andrologia 2021; 53:e14136. [PMID: 34115901 PMCID: PMC8420368 DOI: 10.1111/and.14136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/21/2021] [Accepted: 05/18/2021] [Indexed: 01/10/2023] Open
Abstract
The effect of COVID-19 on the male reproductive tract has been sparsely studied. This exploratory study was designed to determine the presence of SARS-CoV-2 in the semen of men recovering from COVID-19. A systematic literature review was also performed as per PRISMA guidelines to gather perspective on this topic. The prospective study included men 21 years and older recovering from COVID-19 with nasopharyngeal swab negative for SARS-CoV-2 or at least two weeks from the last COVID RT-PCR positivity. After clinical evaluation, freshly ejaculated semen sample by masturbation was collected in a sterile container. Samples were processed for the detection of SARS-CoV-2 by RT-PCR. Twenty-one patients were contacted for the study, 11 of which consented to provide a semen sample. The mean age of the cohort was 29.72 ± 4.52 years. None of the patients gave a history of epididymo-orchitis or sexual dysfunction at the time of assessment. None of the semen samples demonstrated SARS-CoV-2 on RT-PCR. Median duration of semen sample collection from the COVID positivity was 44 days (Range 19-59 days). Detailed literature review revealed that SARS-CoV-2 is not found in patients recovering from COVID-19 infection. We conclude that SARS-CoV-2 is not found in the semen of patients recovering from COVID-19.
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Affiliation(s)
| | | | - Kapil Goyal
- Department of Virology, PGIMER, Chandigarh, India
| | | | | | - Vikrant Sharma
- Regional VDRL, Department of virology, PGIMER, Chandigarh, India
| | | | - Mini P Singh
- Department of Virology, PGIMER, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, PGIMER, Chandigarh, India
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22
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Paoli D, Pallotti F, Nigro G, Aureli A, Perlorca A, Mazzuti L, Di Carlo D, Turriziani O, Lenzi A, Lombardo F. Sperm cryopreservation during the SARS-CoV-2 pandemic. J Endocrinol Invest 2021; 44:1091-1096. [PMID: 33040303 PMCID: PMC7547554 DOI: 10.1007/s40618-020-01438-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/26/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Sperm cryopreservation is fundamental in the management of patients undergoing gonadotoxic treatments. Concerns have risen in relation to SARS-CoV-2 and its potential for testicular involvement, since SARS-CoV-2-positive cryopreserved samples may have unknown effects on fertilization and embryo safety. This study therefore aimed to analyze the safety of sperm cryopreservation for cancer patients after the onset of the pandemic in Italy, through assessment of the risk of SARS-CoV-2 exposure and viral RNA testing of semen samples. METHODS We recruited 10 cancer patients (mean age 30.5 ± 9.6 years) referred to our Sperm Bank during the Italian lockdown (from March 11th to May 4th 2020) who had not undergone a nasopharyngeal swab for SARS-CoV-2 testing. Patients were administered a questionnaire on their exposure to COVID-19, and semen samples were taken. Before cryopreservation, SARS-CoV-2 RNA was extracted from a 150 µl aliquot of seminal fluid in toto using QIAamp viral RNA kit (Qiagen) and amplified by a real time RT PCR system (RealStar SARS-CoV2 RT PCR, Altona Diagnostics) targeting the E and S genes. RESULTS The questionnaire and medical interview revealed that all patients were asymptomatic and had had no previous contact with COVID-19 infected patients. All semen samples were negative for SARS-CoV-2 RNA. CONCLUSION This preliminary assessment suggests that a thorough evaluation (especially in the setting of a multidisciplinary team) and molecular confirmation of the absence of SARS-CoV-2 in seminal fluid from asymptomatic cancer patients may assist in ensuring the safety of sperm cryopreservation.
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Affiliation(s)
- D. Paoli
- Laboratory of Seminology - Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - F. Pallotti
- Laboratory of Seminology - Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - G. Nigro
- Laboratory of Seminology - Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - A. Aureli
- Laboratory of Seminology - Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - A. Perlorca
- Laboratory of Seminology - Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - L. Mazzuti
- Laboratory of Virology, Department of Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - D. Di Carlo
- Laboratory of Virology, Department of Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - O. Turriziani
- Laboratory of Virology, Department of Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - A. Lenzi
- Laboratory of Seminology - Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - F. Lombardo
- Laboratory of Seminology - Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
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23
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Teixeira TA, Bernardes FS, Oliveira YC, Hsieh MK, Esteves SC, Duarte AN, Kallas EG, Hallak J. SARS-CoV-2 and Multi-Organ damage - What men's health specialists should know about the COVID-19 pathophysiology. Int Braz J Urol 2021; 47:637-646. [PMID: 33621014 PMCID: PMC7993942 DOI: 10.1590/s1677-5538.ibju.2020.0872] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 02/08/2023] Open
Affiliation(s)
- Thiago A. Teixeira
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloDivisão de Clinica UrológicaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Divisão de Clinica Urológica Universidade de São Paulo - USP, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Universidade Federal do AmapáFaculdade de MedicinaDivisão de UrologiaAmapáAPBrasilDivisão de Urologia, Faculdade de Medicina, Universidade Federal do Amapá - UNIFAP, Amapá, AP, Brasil
| | - Felipe S. Bernardes
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloDivisão de Clinica UrológicaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Divisão de Clinica Urológica Universidade de São Paulo - USP, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
| | - Yasmin C. Oliveira
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Universidade Federal do AmapáFaculdade de MedicinaDivisão de UrologiaAmapáAPBrasilDivisão de Urologia, Faculdade de Medicina, Universidade Federal do Amapá - UNIFAP, Amapá, AP, Brasil
| | - Mariana K. Hsieh
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Faculdade de MedicinaCiências da Saúde Albert EinsteinFaculdade IsraelitaSão PauloSPBrasilFaculdade Israelita de Ciências da Saúde Albert Einstein, Faculdade de Medicina, São Paulo, São Paulo, SP, Brasil
| | - Sandro C. Esteves
- Clínica de Andrologia e Reprodução HumanaCampinasSPBrasilANDROFERT, Clínica de Andrologia e Reprodução Humana, Campinas, SP, Brasil
- Universidade Estadual de CampinasDepartamento de CirurgiaCampinasSPBrasilDepartamento de Cirurgia, Disciplina de Urologia, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil
- Aarhus UniversityFaculty of HealthAarhusDenmarkFaculty of Health, Aarhus University, Aarhus, Denmark
| | - Amaro N. Duarte
- Universidade de São PauloDepartamento de PatologiaSão PauloSPBrasilBIAS - Grupo de Estudos de Autópsia de Imagens Brasileiras, Departamento de Patologia, Universidade de São Paulo, SP, Brasil
| | - Esper G. Kallas
- Universidade de São PauloDepartamento de Doenças Infecciosas e ParasitáriasSão PauloSPBrasilDepartamento de Doenças Infecciosas e Parasitárias, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Jorge Hallak
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloDivisão de Clinica UrológicaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Divisão de Clinica Urológica Universidade de São Paulo - USP, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Universidade de São PauloDepartamento de PatologiaUnidade de Toxicologia ReprodutivaSão PauloSPBrasilUnidade de Toxicologia Reprodutiva, Departamento de Patologia, Universidade de São Paulo, São Paulo, SP, Brasil
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24
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Synowiec A, Szczepański A, Barreto-Duran E, Lie LK, Pyrc K. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Systemic Infection. Clin Microbiol Rev 2021; 34:e00133-20. [PMID: 33441314 PMCID: PMC7849242 DOI: 10.1128/cmr.00133-20] [Citation(s) in RCA: 128] [Impact Index Per Article: 42.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
To date, seven identified coronaviruses (CoVs) have been found to infect humans; of these, three highly pathogenic variants have emerged in the 21st century. The newest member of this group, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected at the end of 2019 in Hubei province, China. Since then, this novel coronavirus has spread worldwide, causing a pandemic; the respiratory disease caused by the virus is called coronavirus disease 2019 (COVID-19). The clinical presentation ranges from asymptomatic to mild respiratory tract infections and influenza-like illness to severe disease with accompanying lung injury, multiorgan failure, and death. Although the lungs are believed to be the site at which SARS-CoV-2 replicates, infected patients often report other symptoms, suggesting the involvement of the gastrointestinal tract, heart, cardiovascular system, kidneys, and other organs; therefore, the following question arises: is COVID-19 a respiratory or systemic disease? This review aims to summarize existing data on the replication of SARS-CoV-2 in different tissues in both patients and ex vivo models.
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Affiliation(s)
- Aleksandra Synowiec
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Artur Szczepański
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
- Microbiology Department, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland
| | - Emilia Barreto-Duran
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Laurensius Kevin Lie
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
| | - Krzysztof Pyrc
- Virogenetics Laboratory of Virology, Malopolska Centre of Biotechnology, Jagiellonian University, Krakow, Poland
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25
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Carneiro F, Teixeira TA, Bernardes FS, Pereira MS, Milani G, Duarte-Neto AN, Kallas EG, Saldiva PHN, Chammas MC, Hallak J. Radiological patterns of incidental epididymitis in mild-to-moderate COVID-19 patients revealed by colour Doppler ultrasound. Andrologia 2021; 53:e13973. [PMID: 33565141 PMCID: PMC7994978 DOI: 10.1111/and.13973] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 12/13/2022] Open
Abstract
The testis is a potential target organ for SARS-CoV-2 infection. Our study intended to investigate any testicular involvement in mild-to-moderate COVID-19 men. We conduct a cross-sectional study in 18 to 55-year-old men hospitalised for confirmed COVID-19. A senior radiologist executed the ultrasound with multi-frequency linear probe in all participants, regardless of any scrotal complaints. Exclusion criteria involved any situation that could impair testicular function. Statistical analysis compared independent groups, classified by any pathological change. Categorical and numerical outcome hypotheses were tested by Fisher's Exact and Mann-Whitney tests, using the Excel for Mac, version 16.29 (p < .05). The sample size was 26 men (mean 33.7 ± 6.2 years; range: 21-42 years), all without scrotal complaints. No orchitis was seen. Eleven men (32.6 ± 5.8 years) had epididymitis (42.3%), bilateral in 19.2%. More than half of men with epididymitis displayed epididymal head augmentation > 1.2 cm (p = .002). Two distinct epididymitis' patterns were reported: (a) disseminated micro-abscesses (n = 6) and (b) inhomogeneous echogenicity with reactional hydrocele (n = 5). Both patterns revealed increased epididymal head, augmented Doppler flow and scrotal skin thickening. The use of colour Doppler ultrasound in mild-to-moderate COVID-19 men, even in the absence of testicular complaints, might be useful to diagnose epididymitis that could elicit fertility complications.
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Affiliation(s)
- Felipe Carneiro
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.,Department of Radiology, University of São Paulo, Sao Paulo, Brazil
| | - Thiago A Teixeira
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.,Division of Urology, University of São Paulo, Sao Paulo, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, Sao Paulo, Brazil.,Division of Urology, School of Medicine, Federal University of Amapa, Macapa, Brazil
| | - Felipe S Bernardes
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.,Division of Urology, University of São Paulo, Sao Paulo, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, Sao Paulo, Brazil
| | | | - Giovanna Milani
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.,ABC School of Medicine, Santo Andre, Brazil
| | - Amaro N Duarte-Neto
- BIAS - Brazilian Image Autopsy Study Group, Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil
| | - Esper G Kallas
- Department of Infectious and Parasitic Diseases, University of São Paulo, Sao Paulo, Brazil
| | - Paulo H N Saldiva
- BIAS - Brazilian Image Autopsy Study Group, Department of Pathology, University of Sao Paulo, Sao Paulo, Brazil.,Reproductive Toxicology Unit, Department of Pathology, University of São Paulo, Sao Paulo, Brazil
| | - Maria C Chammas
- Department of Radiology, University of São Paulo, Sao Paulo, Brazil
| | - Jorge Hallak
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, Sao Paulo, Brazil.,Division of Urology, University of São Paulo, Sao Paulo, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, Sao Paulo, Brazil.,Reproductive Toxicology Unit, Department of Pathology, University of São Paulo, Sao Paulo, Brazil
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26
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Sansone A, Mollaioli D, Ciocca G, Limoncin E, Colonnello E, Vena W, Jannini EA. Addressing male sexual and reproductive health in the wake of COVID-19 outbreak. J Endocrinol Invest 2021; 44:223-231. [PMID: 32661947 PMCID: PMC7355084 DOI: 10.1007/s40618-020-01350-1] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE The COVID-19 pandemic, caused by the SARS-CoV-2, represents an unprecedented challenge for healthcare. COVID-19 features a state of hyperinflammation resulting in a "cytokine storm", which leads to severe complications, such as the development of micro-thrombosis and disseminated intravascular coagulation (DIC). Despite isolation measures, the number of affected patients is growing daily: as of June 12th, over 7.5 million cases have been confirmed worldwide, with more than 420,000 global deaths. Over 3.5 million patients have recovered from COVID-19; although this number is increasing by the day, great attention should be directed towards the possible long-term outcomes of the disease. Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients. METHODS A literature research on the possible mechanisms involved in the development of ED in COVID-19 survivors was performed. RESULTS Endothelial dysfunction, subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics all contribute to the potential onset of ED. Additionally, COVID-19 might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED. Testicular function in COVID-19 patients requires careful investigation for the unclear association with testosterone deficiency and the possible consequences for reproductive health. Treatment with phosphodiesterase-5 (PDE5) inhibitors might be beneficial for both COVID-19 and ED. CONCLUSION COVID-19 survivors might develop sexual and reproductive health issues. Andrological assessment and tailored treatments should be considered in the follow-up.
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Affiliation(s)
- A Sansone
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - D Mollaioli
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - G Ciocca
- Department of Dynamic and Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - E Limoncin
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - E Colonnello
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy
| | - W Vena
- Endocrinology, Diabetology and Andrology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, MI, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - E A Jannini
- Chair of Endocrinology and Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
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27
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Teixeira TA, Oliveira YC, Bernardes FS, Kallas EG, Duarte-Neto AN, Esteves SC, Drevet JR, Hallak J. Viral infections and implications for male reproductive health. Asian J Androl 2021; 23:335-347. [PMID: 33473014 PMCID: PMC8269834 DOI: 10.4103/aja.aja_82_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Viral infections have haunted humankind since times immemorial. Overpopulation, globalization, and extensive deforestation have created an ideal environment for a viral spread with unknown and multiple shedding routes. Many viruses can infect the male reproductive tract, with potential adverse consequences to male reproductive health, including infertility and cancer. Moreover, some genital tract viral infections can be sexually transmitted, potentially impacting the resulting offspring's health. We have summarized the evidence concerning the presence and adverse effects of the relevant viruses on the reproductive tract (mumps virus, human immunodeficiency virus, herpes virus, human papillomavirus, hepatitis B and C viruses, Ebola virus, Zika virus, influenza virus, and coronaviruses), their routes of infection, target organs and cells, prevalence and pattern of virus shedding in semen, as well as diagnosis/testing and treatment strategies. The pathophysiological understanding in the male genital tract is essential to assess its clinical impact on male reproductive health and guide future research.
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Affiliation(s)
- Thiago A Teixeira
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, University of São Paulo, São Paulo 05403-000, SP, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo 05508-060, SP, Brazil.,Division of Urology, School of Medicine, Federal University of Amapa, Macapa 68903-419, AP, Brazil
| | - Yasmin C Oliveira
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, School of Medicine, Federal University of Amapa, Macapa 68903-419, AP, Brazil
| | - Felipe S Bernardes
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, University of São Paulo, São Paulo 05403-000, SP, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo 05508-060, SP, Brazil
| | - Esper G Kallas
- Department of Infectious and Parasitic Diseases, University of São Paulo, São Paulo 05403-000, SP, Brazil
| | - Amaro N Duarte-Neto
- BIAS - Brazilian Image Autopsy Study Group, Department of Pathology, University of São Paulo, São Paulo 05403-000, SP, Brazil
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas 13075-460, SP, Brazil.,Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas 13083-968, SP, Brazil.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus 8000, Denmark
| | - Joël R Drevet
- GReD Institute, CNRS-INSERM-Université Clermont Auvergne, Faculty of Medicine, Clermont-Ferrand 63000, France
| | - Jorge Hallak
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Research Andrology Laboratory, São Paulo 04534-011, SP, Brazil.,Division of Urology, University of São Paulo, São Paulo 05403-000, SP, Brazil.,Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo 05508-060, SP, Brazil.,Reproductive Toxicology Unit, Department of Pathology, University of São Paulo, São Paulo 05403-000, SP, Brazil
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Wiweko B, Ho TM, Li R, Li TC, Tzeng CR, Kovacs G, Tanaka A, Lee JR, Pai H, Khan HL. SARS-CoV-2 and Assisted Reproductive Technology Practice: An Asia Pacific Initiative on Reproduction (ASPIRE) Position Paper. FERTILITY & REPRODUCTION 2020. [DOI: 10.1142/s2661318220500188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background: Asia Pacific Initiative on Reproduction (ASPIRE) aims to improve knowledge and awareness of Assisted Reproductive Technology (ART) and infertility-related services, with the aim of improving the quality of patient care. Methods: A survey was developed and responded by a group of 10 ASPIRE board members to gather in-depth information about current practices, recommendations, and perceptions about SARS-CoV-2 and ART. The collected data were summarized and individual responses pooled among questions requiring voting. The overall rates were computed by response category. The group discussed the summary evidence, until a consensus was reached concerning a series of recommendation on how to make decisions concerning ART service provision during the current (and any future) pandemic. A two-tier recommendation was developed based on agreement rate and implementation priority. Tier 1 comprises recommendations in which the rate of “absolutely agree” responses were [Formula: see text]60%, whereas tier 2 refers to recommendations in which the rate of “absolutely agree” plus “agree” was >60%, but the rate of “absolutely agree” was [Formula: see text]50%. Results: The survey was responded by all participants between July 24 and July 30, 2020. Nine tier 1 and five tier 2 recommendations are provided concerning prevention, testing, personal protective equipment, informed consent, and quality management. The former indicates the situations in which most individuals should receive the intervention/procedure, whereas the latter relates to those that may be suitable for individual clinics and patients. Conclusions: This document provides the ASPIRE viewpoint on better managing infertile patients seeking ART during the COVID-19 pandemic. This expert opinion guide aims to help both competent authorities and healthcare providers to deliver quality and safe ART.
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Affiliation(s)
- Budi Wiweko
- Department Obstetric Gynecology Faculty of Medicine Universitas Indonesia — Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Tuong M. Ho
- IVFMD, My Duc Hospital, Ho Chi Minh City, Vietnam
| | - Rong Li
- Department of OB & GYN, Reproductive Medical Center, Peking University Third Hospital, Beijing, China
| | - Tin-Chiu Li
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
| | | | | | | | - Jung Ryeol Lee
- Department Obstetric Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Korea
| | - Hrishikesh Pai
- Medical Director, Lilavati Hospital IVF and Bloom IVF Group India
| | - Haroon Latif Khan
- Lahore Institute of Fertility and Endocrinology, Hameed Latif Hospital, Lahore, Pakistan
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