The Role of SARS-CoV-2 in Male Reproduction

Document Type : Mini Review


Academic Area of Medicine, Institute of Health Sciences at Autonomous University of the State of Hidalgo. Ex-hacienda la Concepción, Tilcuautla C.P. 420160, Pachuca de Soto, Hidalgo, México


 COVID19 is an infectious disease transmitted by the SARS-CoV-2 virus, whose outbreak was declared a pandemic in March 2020. To date, on November 17, 2020, 55,243,538 confirmed cases had been reported worldwide. Epidemiological studies in different countries have shown higher morbidity and mortality in male than in female patients. The relationship between the COVID-19 disease and the renin-angiotensin-aldosterone (RAA) system has also been documented. The SARS-CoV-2 enters cells through a receptor called angiotensin-converting enzyme-2 (ACE2) and a serine protease (TMPRSS2), both widely expressed in the body, including the testes. ACE2 belongs to the RAA system, which is also expressed in the male reproductive system, and its absence causes infertility. Moreover, ADAM17 is a metalloprotease responsible for inflammation and spermatogenesis and is activated by SARS-CoV-ECA2. Knowledge about the consequences of SARS-CoV-2 infection on male reproduction, as well as the possibility of sexual transmission, is still limited. This review summarizes the available evidence to analyze the effect of SARS-CoV-2 infection on male reproduction and its possible sexual transmission. The reproductive consequences caused by COVID-19 are currently unknown. Although most studies have shown the absence of SARS-COV-2 in the semen and prostate secretion, there is evidence of testicular tissue alteration accompanied by inflammatory infiltration in viral orchitis. These results suggest that there may be a deterioration in the testicular function that could lead to infertility. Also, more studies are needed to assess the risk of sexual transmission.