SARS-CoV-2 infection: implications for sexual and reproductive health. A position statement of the Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva (ASESA)
Por:
Jose, FG, Gonzalez, JGA, Molina, JMC, Arnau, LB, Iribarren, IM, Jabaloyas, JMM, Rico, FM, Garcia-Baquero, R, Gaya, MR, Garcia, EL, Lopez, CL, Castro, RP, Salamanca, JIM
Publicada:
1 jul 2020
Resumen:
Objective: The main objective of this revision is to summarize the current existing evidence of the potential adverse effects of SARS-CoV-2 on the male reproductive system and provide the recommendations of the Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva (ASESA) concerning the implications of COVID-19 infection in the management of male infertilty patients and testicular endocrine dysfunction.
Methods: A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out.
Results: The presence of orchitis as a potential complication of the infection by SARS-CoV-2 has not yet been confirmed. One study reported that 19% of males with COVID-19 infection had scrotal symptoms suggestive of viral orchitis which could not be confirmed. It is possible that the virus, rather than infecting the testes directly, may induce a secondary autoimmune response leading to autoimmune orchitis. COVID-19 has been associated with coagulation disorders and thus the orchitis could be the result of segmental vasculitis. Existing data concerning the presence of the virus in semen are contradictory. Only one study reported the presence of RNA in 15.8% of patients with COVID-19. However, the presence of nucleic acid or antigen in semen is not synonyms of viral replication capacity and infectivity.
It has been reported an increase in serum levels of LH in males with COVID-19 and a significant reduction in the T/LH and FSH/LH ratios, consistent with subclinical hypogonadism.
Conclusions: The findings of recent reports related to the potential effects of COVID-19 infection on the male reproductive system are based on poorly designed, small sample size studies that provide inconclusive, contradictory results. Since there still exists a theoretical possibility of testicular damage and mate infertilty as a result of the infection by COVID-19, males of reproductive age should be evaluated for gonadal function and semen analysis. With regard to the sexual transmission of the virus, there is not sufficient evidence to recommend asymptomatic couples to abstein from having sex in order to protect themselves from being infected by the virus.
Additional studies are needed to understand the long-term effects of SARS-CoV-2 on male reproductive function, including male fertility potential and endocrine testicular function. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva.
Filiaciones:
Jose, FG:
Inst Marques, Unidad Androl, Avinguda Diagonal 662-664, Barcelona 08034, Spain
Gonzalez, JGA:
Ctr ANDROGEN, La Coruna, Spain
Harvard Med Sch, Boston, MA 02115 USA
Molina, JMC:
Hosp Clin Barcelona, Serv Urol, Barcelona, Spain
Arnau, LB:
Univ Autonoma Barcelona, Fdn Puigvert, Serv Androl, Barcelona, Spain
Iribarren, IM:
Hosp Univ La Zarzuela, Serv Urol, Madrid, Spain
Jabaloyas, JMM:
Hosp Clin Univ Valencia, Serv Urol, Valencia, Spain
Rico, FM:
Hosp Povisa, Serv Urol, Vigo, Pontevedra, Spain
Garcia-Baquero, R:
Hosp Univ Puerta del Mar, Serv Urol, Cadiz, Spain
Gaya, MR:
Inst Med Rossello, Ctr Asoc Quiron Palma Planas, Palma De Mallorca, Spain
Garcia, EL:
Hosp Gen Univ Gregorio Maranon, Serv Urol, Madrid, Spain
Lopez, CL:
Ctr Salud Albarizas Marbella, Malaga, Spain
Castro, RP:
Hosp Reina Sofia, Unidad Clin Urol, Unidad Androl Med Sexual & Reprod, Cordoba, Spain
Salamanca, JIM:
Univ Autonoma Madrid, Hosp Univ Puerta de Hierro Majadahonda, Serv Urol, Madrid, Spain
Green Published, Bronze
|