Men who have recovered from COVID-19 are at risk of becoming low sperm count, at least in the short term, suggests a small new study.
Researchers from the University of Florence in Italy analyzed the semen samples from 43 men aged 30 to 65 about one month after recovering from COVID-19. They found that 25% of the men had a low sperm count and that almost 20% had azoospermia, or the total absence of sperm in semen. According to the site, this is much higher than the prevalence of azoospermia in the general population worldwide Johns Hopkins School of Medicine.
In addition, participants with severe COVID-19 infections – those admitted to the hospital or admitted to the intensive care unit (IUC) – were more likely to have azoospermia after their infection, compared to those with less severe infections, according to the study, published. February 1 in the journal Human reproduction.
However, the researchers emphasize that their study does not prove that SARS-CoV-2, the virus that causes COVID-19, harms sperm. The researchers do not know what the sperm count of the men was before their infections, and therefore the authors cannot say with certainty whether the scores decreased after infection; but all the men with azoospermia had children before, which means they had at least one viable sperm in the past, the report said. In addition, it is possible that the medicines given for the treatment of COVID-19, such as antiviral drugs, antibiotics and corticosteroids, may affect the sperm count.
If you are sick, it can affect semen. “The sicker you are, the more it can work out,” said Dr. Ajay Nangia, a professor and vice president of urology at the University of Kansas’ health system, said, who was not involved in the study.
Dr Boback Berookhim, director of male fertility and microsurgery at Lenox Hill Hospital in New York City, agreed. “This may not be a specific COVID phenomenon and may (and probably is!) Due to the fact that these patients have a more serious illness [and requiring] intensive care, ”Berookhim told WordsSideKick via email.
Nangia added that these men should be followed for a minimum of 90 days after the disease to see if the effect is long lasting as it takes several months to fully mature sperm. “You have to repeat the study on these people after the 90-day mark,” to know if the effect is prolonged, he said.
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COVID-19 and fertility
There is reason to believe that SARS-CoV-2 may affect sperm production. Testicular cells have high levels of the ACE2 receptor, which allows SARS-CoV-2 to enter cells, the authors said.
However, only a handful of studies looked at SARS-CoV-2 in semen from men who tested positive for the virus; these studies found the coronavirus in semen of some men, but not all, during infection or recovery.
At least one other study from China, published in the October 2020 issue of the journal EClinicalMedicine, found lower sperm counts in men who had COVID-19, but this small study included only 23 patients.
For the new study, the researchers collected saliva, urine and semen samples approximately 30 days after recovering from COVID-19, which were defined as two consecutive negative COVID-19 tests.
Of the 43 patients, 12 were treated at home, 26 were admitted to the hospital and five were admitted to the ICU.
In general, eight men had azoospermia and three had oligospermia, or low sperm, which was defined in the study as less than 2 million sperm per milliliter of sperm. (Men are usually considered to have a low sperm count if they have less than 15 million sperm per milliliter of sperm, according to the Mayo Clinic.) The risk of azoospermia was linked to the severity of the men’s disease: azoospermia was found in four out of five of the ICU patients, three of the 26 patients admitted to the hospital and only one of the patients not hospitalized is not.
Only one participant detected SARS-CoV-2 in their semen, indicating that “the presence of virus in semen is a rare occurrence,” after recovery, the authors write.
The researchers also found that three-quarters of the participants in total and 100% of the participants admitted to the ICU had high levels of interleukin 8 (IL-8), Immune system molecule and marker of inflammation, in their semen.
“COVID-19 patients of reproductive age should undergo a careful follow-up for reproductive function and semen parameters,” the authors concluded.
Temporary effect?
According to Nangia, it appears that the disease has at least a temporary effect on the testicles and sperm, based on current study and other previous research. “In the short term, it really looks like that,” Nangia told WordsSideKick. The big question, however, is whether the sperm count of men will increase over time. ‘Is it a persistent, irreversible effect? … We do not know. ‘
Berookhim said he was not convinced that patients infected with COVID-19 necessarily needed long-term follow-up to analyze their sperm. But “we clearly need more data and experience to deal with the aftermath of COVID, and therefore more follow-up will help better define which patients are at greatest risk for adverse reproductive effects due to COVID 19,” he said.
Certain viral diseases are known to affect fertility for a long time. In particular, pumpkins can lead to inflammation of the testicles, known as orchitis, which in some cases can cause infertility. Nangia noted that there have been reports of men with COVID-19 experiencing testicular pain similar to that seen in pumpkins.
Although the new study is one of the largest to date that looked at COVID-19 in semen quality, it is still relatively small, the authors said, and therefore larger studies are also needed to confirm the findings.
Originally published on Live Science.