Researchers from the University of São Paulo (USP) showed, for the first time, that the virus SARS-CoV-2 it can be present in patients' sperm up to 90 days after hospital discharge and up to 110 days after the initial infection, reducing semen quality. The research results, recently published in the journal Andrologywarn of the need to consider a period of “quarantine” after the illness for those who intend to have children.
More than four years after the start of the Covid-19 pandemic, it is now known that the new coronavirus is capable of invading and destroying a series of human cells and tissues, including those of the reproductive system, of which the testicles function as a “gateway”. input”. Although several studies have already observed its greater aggressiveness towards the male genital tract compared to other viruses and even detected SARS-CoV-2 in the male gonad during autopsies, the pathogen is rarely identified in PCR tests. [teste molecular que detecta o material genético viral] of human semen.
To fill this gap in scientific knowledge, the current study, financed by FAPESP, used real-time PCR technologies to detect RNA and transmission electron microscopy (TEM) to analyze spermatozoa ejaculated by men convalescing from Covid-19.
Semen samples were studied from 13 infected patients who developed mild, moderate and severe Covid-19 treated at the Hospital das Clínicas da Faculdade de Medicina (HC-FM-USP), aged between 21 and 50 years, in a period up to 90 days after discharge and 110 days after diagnosis. Although everyone tested negative for the presence of SARS-CoV-2 in the semen PCR test, the virus was identified in sperm from eight of the 11 (72.7%) patients with moderate to severe disease within 90 days of discharge. hospital, which, according to the authors, does not mean that it is not present for longer.
SARS-CoV-2 was also identified in one of the two patients with mild Covid-19. Thus, among the 13 infected, nine (69.2%) had SARS-CoV-2 detected intracellularly in ejaculated sperm. Two other patients presented ultrastructural disorders in the gametes similar to those observed in patients in whom the virus was diagnosed. Therefore, the researchers consider that, in total, there were 11 participants with viral presence within the male gamete.
“More than that, we observed that sperm produce 'extracellular traps' based on nuclear DNA, that is, the genetic material contained in the nucleus decondenses, the sperm cell membranes rupture and the DNA is expelled extracellularly, forming networks similar to those previously described in the systemic inflammatory response to SARS-CoV-2”, reports Jorge Hallak professor at FM-USP and study coordinator.
Hallak refers to an immunological mechanism known as NET [armadilha extracelular neutrofílica, na sigla em inglês], which, as the name suggests, is a defense strategy used mainly by neutrophils, a type of leukocyte capable of phagocytosing bacteria, fungi and viruses and which makes up the front line of the immune system. When this mechanism is activated, neutrophils launch “nets” into the extracellular environment in order to isolate, trap, neutralize and kill invading agents. However, NETs are also harmful to other tissues of the body, when hyperactivated (Read more at: agencia.fapesp.br/33435 ).
Electron microscopy results revealed that spermatozoa produce extracellular traps based on nuclear DNA to neutralize the offending agent and “suicide” themselves in the process. In other words, the cell “sacrifices” itself to contain the pathogen – a mechanism known in English as suicidal ETosis-like response.
“The unprecedented description in the literature that sperm act as part of the innate defense system against invaders gives the study great importance. It can be considered a paradigm shift in science”, says Hallak.
Until then, explains the researcher, there were four known functions of spermatozoa: bringing the genetic content of the male gamete close to the female gamete, fertilizing the female gamete, promoting adequate and critical embryonic development up to the 12th week of gestation and being co-determinant. in the development of several chronic diseases in adulthood, such as infertility, hypogonadism, diabetes, hypertension, some types of cancer and cardiovascular disease, among others.
Now, with this discovery, a new function has been added to the list, in addition to reproduction.
“The possible implications of our findings for the use of sperm in assisted reproduction techniques must be urgently considered and addressed by doctors and regulatory bodies, particularly in the technique used in more than 90% of cases of marital infertility in Brazil, in micromanipulation laboratories. of gametes, which is the injection of a single sperm into the egg – a method known as ICSI [do inglês, intracytoplasmic sperm injection]”, warns Hallak, who advocates postponing natural conception and, particularly, assisted reproduction techniques for at least six months after Covid-19 infection, even in mild cases.
Previous discoveries
One of the first members of the scientific and medical communities to suggest more caution in reproduction protocols during the pandemic, Hallak has been studying the impact of Covid-19 on reproductive and sexual health since 2020, when he worked as a volunteer doctor on the front line of the emergency room at HC-FM-USP.
His research group, which involves collaborators from the Department of Pathology at FM-USP, has already made important discoveries on the subject, such as the fact that males per se be a risk factor for greater mortality and severity of SARS-CoV-2 infection. One of the hypotheses is linked to the fact that the testicles have a large number of ACE2 receptors (protein used by the virus to invade human cells) and the TMPRSS2 protein (responsible for binding the virus to ACE2 receptors), while, in women, the ovaries have only ACE2 receptors.
In another study carried out with members of the Urological Clinic Division of Hospital das Clínicas at FM-USP, the group found a sharp drop in libido and general sexual satisfaction, in addition to an increase in pornography consumption and masturbatory frequency, in health professionals as a result of pandemic.
The USP team found although the testicles are potential target organs for infection by the virus, which causes subclinical epididymitis (inflammation of the epididymis, a tubule 5 to 6 meters long, external and located posterior to the testicles, essential for maturation, acquisition of the ability to egg fertilization and sperm storage). AND demonstrated in an unprecedented way, the severity of testicular injuries associated with Covid-19.
Currently, the group of doctors and scientists from HC-FM-USP, under the coordination of Professor Carlos Carvalho, is evaluating the late effects of SARS-CoV-2 infection in the group of more than 700 affected patients who were initially evaluated , through a Thematic Project financed by FAPESP (Read more at: agencia.fapesp.br/51767 ).
The article Transmission electron microscopy reveals the presence of SARS-CoV-2 in human spermatozoa associated with an ETosis-like response can be read at: https://onlinelibrary.wiley.com/doi/abs/10.1111/andr.13612 .
I am an experienced journalist and writer with a career in the news industry. My focus is on covering Top News stories for World Stock Market, where I provide comprehensive analysis and commentary on markets around the world. I have expertise in writing both long-form articles and shorter pieces that deliver timely, relevant updates to readers.