More than a year after the discovery of the SARS-CoV-2 coronavirus, researchers are still seeking to understand the effects of the infectious agent in the human body. In this scenario, researchers from the Faculty of Medicine of the University of São Paulo (FMUSP) follow male patients who had COVID-19 and observed, in this group, a reduction in the level of testosterone and a smaller amount of sperm.
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Led by andrologist Jorge Hallak, professor at FMUSP and coordinator of the Study Group on Men’s Health at the Institute for Advanced Studies (IEA-USP), a new study on the effects of COVID-19 on male sexual health was published in the scientific journal Andrologia .
In the survey, the researchers were able to observe that the coronavirus can infect the testes, impairing the ability of male gonads to produce sperm and hormones. In fact, the research noted that the results of fertility and hormonal tests remained altered even months after recovering from COVID-19.
Post-COVID infertility?
It is noteworthy that this is still an initial study and does not confirm that COVID-19 can cause infertility in male patients who contracted the infection. In addition, the findings were based on the cases of 26 people who contracted the disease mildly or moderately and had a diagnosis confirmed by tests. These patients had a mean age of 33 years and were treated at the Hospital das Clínicas at FMUSP and at the Androscience Institute of Science and Innovation in Andrology.
In the group, the Brazilian researchers observed that the spermograms of several of these patients indicated, for example, that sperm motility — the ability of sperm to move and fertilize the egg, whose normal rate is above 50% — dropped to between 8% and 12% and remained at this level almost a year after being infected by the virus.
Now, hormonal test results have pointed to the fact that some patients’ testosterone levels have plummeted after the illness. For example, the normal hormone level is 300 to 500 nanograms per deciliter of blood (ng/dL). In some patients with COVID-19, this value ranged below 200 and often ranged between 70 and 80 ng/dL.
“We have increasingly seen prolonged changes in the quality of semen and hormones in patients who had COVID-19, even in those who presented mild or asymptomatic conditions”, commented Professor Hallak to Agência FAPESP.
Coronavirus can infect the testicles
“It is very worrying how the new coronavirus affects the testicles, even in asymptomatic or mildly symptomatic cases of the disease. Among all the agents harmful to the testicles that I have studied to date, SARS-CoV-2 seems to be very active”, explained researcher Hallak about the new research.
“Each pathology has particularities that practice and experience show us. SARS-CoV-2 has the characteristic of affecting spermatogenesis. We are discovering the mechanisms involved, such as persistently very low progressive motility and well altered morphology, with no significant change in sperm concentration”, he adds.
According to the article, more than half of the patients infected with the coronavirus presented inflammation in the epididymis – this is a structure that carries out the storage of sperm and where they acquire the ability to move. “Unlike a classic bacterial infection or by other viruses, such as mumps, which causes swelling and commonly discomfort or pain in the testicles in one third of those affected, epididymitis caused by the new coronavirus is painless and cannot be diagnosed by groping [exame físico] or with the naked eye,” said lica Hallak.
Based on these findings, the researchers recommend that male patients see a urologist or andrologist after contracting the coronavirus. In these cases, tests to measure fertility and hormone production can be performed. “These individuals must be followed up for one to two years after infection, at least, as we still don’t know how the disease evolves”, recommended the researcher.