Each day, clinicians and scientists are learning more about the acute and long-term health effects of COVID-19 on the body.
In a new study from the University of Georgia, researchers examined the potential impact of the virus on male fertility.
They reviewed the ways SARS-CoV-2 might target and infect testicular cells. They found severe COVID-19 infection may lower men’s fertility.
In the study, the team reviewed the available evidence on SARS-CoV-2’s interaction with cells in the body, past research on the impact of other SARS-CoV viruses on the testis and patient reports to determine how COVID could be interacting with testicular tissues and function.
Since the onset of the pandemic, scientists have determined that SARS-CoV-2 can infect multiple organs throughout the body through two major proteins: angiotensin-converting enzyme 2 (ACE2) receptors and transmembrane protease serine 2 (TMPRSS2).
These proteins act as a door through which the virus can enter the cell.
The testis produces both proteins, making them susceptible to viral infection and potential cell damage, argue the authors, and clinical reports support this.
There have been autopsy reports that show some sort of viral entry into the testis as well as downside effects of the virus in the testis.
Infected men may have inflammation and orchitis, testicular pain, as well as the breakdown of the blood-testis barrier—and even in some cases, the virus is actually in ejaculate.
The team says that lingering damage to major organs seen in long COVID patients could also happen within the testis, including damage to the blood-testis barrier, which works as a wall to keep out unwanted things like environmental toxins, viruses and the body’s own immune cells.
The team says the worst-case scenario is if the virus damages the organ’s germline sperm cells, the cells responsible for creating new sperm, that could have lasting effects on fertility and could even lead to birth defects.
Fortunately, most people that are of reproductive age are fairly protected from severe cases, but in the 1% that is affected, the virus could cause a lot of damage.
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The study is published in Nature Reviews Urology. One author of the study is Clayton Edenfield.
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