SARS-CoV-2, the virus responsible for COVID-19, can persist in the sperm of patients for up to 90 days after hospital discharge and up to 110 days after initial infection, potentially affecting semen quality, says Researchers at the University of São Paulo (USP) in Brazil.
The study, published in the journal Andrology, recommends that individuals planning to have children should consider a “quarantine” period after recovering from COVID-19.
COVID: IMPACT ON THE REPRODUCTIVE SYSTEM
Over four years into the pandemic, it is well-documented that SARS -CoV-2 can invade and damage various human tissues, including the reproductive system. The testicles act as a gateway for the virus, which is notably more aggressive towards the male genital tract compared to other viruses. Despite this, SARS-CoV-2 has seldom been detected in semen via polymerase chain reaction (PCR) tests focusing on viral DNA.
STUDY METHODOLOGY AND FINDINGS
To address this gap, the study utilized real-time PCR and transmission electron microscopy (TEM) to detect viral RNA in semen and sperm from men recovering from COVID-19. The samples came from 13 patients aged 21 to 50, who had experienced varying severities of COVID-19 and had been admitted to Hospital das Clínicas (HC), the medical school complex at USP.
KEY RESULTS
PCR Tests: Negative for SARS-CoV-2 in semen across all cases.
Sperm Analysis: Viral RNA was detected in sperm from 8 of 11 moderate to severe cases (72.7%) within 90 days post-discharge.
Mild Cases: Detected in one patient, with an overall detection in 9 of 13 patients (69.2%).
Additionally, two patients exhibited ultra structural gamete impairment similar to those diagnosed with COVID-19, suggesting that 11 patients had the virus in their sperm.
MECHANISM AND IMPLICATIONS
Jorge Hallak, a professor at FM-USP and the study’s corresponding author, explained that sperm exhibited “extracellular traps” formed by nuclear DNA. This process, where genetic material is expelled to neutralize the pathogen, is part of a mechanism known as suicidal ETosis-like response. This response highlights sperm’s role in the innate immune system, a novel finding that represents a paradigm shift in scientific understanding.
Hallak emphasized the importance of considering these findings in the context of assisted reproduction, particularly the intracytoplasmic sperm injection (ICSI) technique. He advocates for postponing both natural conception and assisted reproduction for at least six months post-infection to ensure safety and reduce risks associated with SARS-CoV-2 presence in sperm.
Hallak’s research group has been pivotal in uncovering COVID-19’s impact on reproductive health. Their previous work includes:
Highlighting increased risks of severe COVID-19 in men due to higher ACE2 and TMPRSS2 levels in testes.
Observing a decline in libido and sexual satisfaction among health workers during the pandemic.
Identifying subclinical epididymitis and severe testicular lesions linked to COVID-19.
Currently, the team is investigating long-term effects of SARS-CoV-2 in over 700 patients as part of a Thematic Project funded by FAPESP.
The study from USP underscores the significant impact of COVID-19 on male reproductive health, revealing the prolonged presence of SARS-CoV-2 in sperm and its potential implications for fertility. As the world continues to grapple with the long-term effects of the virus, these findings highlight the need for cautious approaches to conception and assisted reproduction following COVID-19 infection.