[ad_1]
Editor’s Note: Find the latest news and advice on COVID-19 in Medscape’s Coronavirus Resource Center.
COVID-19 negatively impacts several markers of inflammation and oxidative stress in semen, says a new prospective longitudinal study from Iran.
“We provide the first direct experimental evidence that the male reproductive system could be targeted and damaged by COVID-19 infection,” the authors note in their article published online Jan. 29 in The reproduction.
Led by doctoral student Behzad Hajizadeh Maleki, who currently works at Justus Liebig University in Giessen, Germany, the researchers say the magnitude of the adverse effects on semen is related to the severity of the disease, and they recognize that the impact appears to diminish over time.
Nonetheless, the results indicate that the testes “should be … declared a high-risk organ by the World Health Organization,” Maleki said in a press release.
And based on their findings, it also suggests that the reproductive function of younger men recovering from COVID-19 be monitored.
Experts say all effects may be temporary
However, based on other evidence to date, fertility experts have insisted that there shouldn’t be an overreaction to this study.
“I have to take a strong note of caution in interpreting this data,” said Allan Pacey, MD, professor of andrology at the University of Sheffield, UK. Medscape Medical News.
He recently reviewed 14 published primary research articles and came to a very different conclusion than Maleki and colleagues. “To date, other articles have been published making this issue a concern [rather] than real primary data that seeks to confirm or disprove the hypothesis, ”he said.
“My opinion is that the data published to date seemed broadly reassuring that any measurable effect of the coronavirus on male fertility is likely only mild and temporary.” But he added: “It is of course important that we keep this [subject] in the study.”
Channa Jayasena, PhD, Reader in Reproductive Endocrinology and Andrology, Imperial College London, UK, said that because the angiotensin converting enzyme receptor 2 (ACE2) – used by the SARS CoV virus -2 to enter cells – is found in the testes. there have been concerns that male fertility may be impaired following infection.
But he pointed out that illness from many viruses can cause sperm count to drop temporarily, sometimes to zero, for a few weeks or months.
“This makes it difficult to determine to what extent the reductions seen in this study were specific to COVID-19 rather than just being sick,” Jayasena told the UK Science Media Center.
It’s also possible that differences in body composition and in therapies administered between men who had COVID-19 and healthy controls could explain the results, experts say.
A wide range of markers for male fertility studied
The ACE2 receptor is abundant in the testes and other male reproductive organs like the prostate, seminal vesicles, and bulb-urethral glands that contribute seminal fluid to semen, the study authors say.
Prior to this new study, the effects of COVID-19 on male reproductive function were unclear, Maleki said.
“We aimed to study a wide variety of markers related to male reproductive health and reproductive function that may lead to more precise and precise conclusions in this regard,” he explained.
Researchers examined changes in seminal ACE2 activity, pro and anti-inflammatory cytokines, oxidative and antioxidant parameters, apoptotic variables (cell death) and sperm quality parameters in 84 men of age of birth. child (20 to 40 years old) with laboratory-confirmed COVID. -19 admitted to Masih Daneshvari Hospital, Tehran, Iran, between March and April 2020.
The time between the confirmatory diagnosis of COVID-19 and the first semen collection was 15.2 ± 5.9 days, and further semen samples were taken 10, 20, 30, 40, 50 and 60 days later.
They compared these results with those of semen samples from 105 healthy controls of the same age.
It was assumed that all men were previously fertile based on a physical examination and history, assessed by a urologist.
Sperm concentration, reduced motility, but did the study end too early?
Among participants who tested positive for COVID-19, 1.2% were diagnosed as mild, 27.4% as moderate, 32.1% as severe, and 39.3% as critical.
ACE2 activity was significantly higher in men in the COVID-19 infected group than in controls (P <0.05) and tended to decrease over time, with a significant decrease from 30 to 60 days (P <0.05).
In comparison, there were no significant changes in ACE2 activity in the control group.
In addition, patients with COVID-19 had significantly higher levels of pro-inflammatory markers (IL-1β, IL-6, IL-8, IL-10, TGF-β, INF-α and INF-γ) that the witnesses (P <0.05) throughout the follow-up.
“The blinding array of measurements to examine the effect of inflammatory markers, or markers of oxidative stress, in semen …[show] interesting differences, but no surprise, ”Pacey remarked.
Maleki said, “In men with COVID-19, markers of inflammation and oxidative stress in sperm increased significantly by over 100% compared to healthy controls of the same age.”
“The pathways that facilitate sperm death were activated; and sperm concentration was reduced by 516%, motility by 209%, and sperm morphology was altered by 400%,” he explained.
“This condition represents oligoasthenoteratozoospermia, which is one of the most common causes of subfertility in men.”
However, Pacey was laudatory about one aspect of the study: the fact that the researchers were “able to repeat these measurements every 10 days over a period of 60 days,” which he described as “a feat.
But “since full sperm production usually takes a little less than 3 months, in my opinion they completed the study 30 days too early. It would have been more helpful to see if there was a difference at 90 days between both groups, ”he observed.
Could Obesity and COVID-19 Treatments Explain Some Findings?
Pacey also pointed out that the study’s authors claim a cause-and-effect relationship between COVID-19 infection and significant alterations in male reproductive function, but their results show only one association.
“There are significant differences in the characteristics of men infected with COVID-19 and those who were not. Body mass index and waist circumference of the control group were significantly different. [for example]Pacey said.
The authors recognize that there are limits to their study. Note the inability to conduct an analysis based on a benign course of the disease due to an insufficient number of patients.
But they add that comparisons between moderate, severe and severely infected men show that the magnitude of the disturbances in the variables studied was related to the severity of the disease.
Nonetheless, they agree that further studies in larger cohorts with extended follow-up periods are needed.
And they recognize that treatment with steroids, antiviral and antiretroviral therapy can cause testicular damage and can adversely affect sperm quality and function, and could “explain the detrimental effects of COVID-19 infection on the body. male reproductive system ”.
Sheena Lewis, PhD, professor of reproductive medicine at Queen’s University Belfast, said those are all valid points.
“I am concerned that men with COVID will have significantly higher body weight and are undergoing a number of therapeutic treatments. We know that obesity alone reduces the quality of sperm. COVID treatments may also have affected the quality of these men’s semen, rather than the COVID itself, ”she told the UK Science Media Center.
The reproduction. Posted on January 29, 2021. Summary
Maleki did not report any relevant financial relationship. Pacey stated that he was Chairman of the Advisory Board of the UK National External Quality Assurance Schemes in Andrology, Editor-in-Chief of Human Fertility, Director of the Progress Educational Trust and Director of the British Fertility Society (all unpaid). Jayasena said she holds a National Institute for Health Research (NIHR) scholarship in male infertility research. He is also a media ambassador for the Society for Endocrinology. Lewis is CEO of Examlab.
For more information on diabetes and endocrinology, follow us on Twitter and Facebook.
[ad_2]
Source link