ECE2022 Poster Presentations Reproductive and Developmental Endocrinology (61 abstracts)
Andrological effects of SARS-Cov2 infection: a systematic review and meta-analysis
Walter Vena 1 , Giovanni Corona 2 , Alessandro Pizzocaro 1 , Francesco Pallotti 3 , Donatella Paoli 3 , Giulia Rastrelli 4 , Elisabetta Baldi 4 , Nicola Cilloni 5 , Federico Semeraro 5 , Andrea Salonia 6 , Suks Minhas 7 , Rosario Pivonello 8 , Alessandra Sforza 2 , Linda Vignozzi 4 , Andrea Marcello Isidori 3 , Andrea Lenzi 3 , Mario Maggi 9 & Francesco Lombardo 3
1Humanitas Research Hospital, Endocrinology, Diabetology and Andrology Unit, Rozzano (MI), Italy; 2Azienda Usl, Maggiore-Bellaria Hospital, Endocrinology Unit, Medical Department, Bologna, Italy; 3Sapienza University of Rome, Department of Experimental Medicine, Roma, Italy; 4University of Florence, Department of Experimental and Clinical Biomedical Science - Andrology, Women’s Endocrinology and Gender Incongruence Unit, Florence, Italy; 5Maggiore Bellaria Hospital, Department of Anaesthesia, Intensive Care and EMS, Bologna, Italy; 6University Vita-Salute San Raffaele, Department of Urology, Milan, Italy; 7Imperial Healthcare NHS Trust, Department of Urology, Charing Cross Hospital, London, United Kingdom; 8Federico II University of Naples, Staff of UNESCO Chair for Health Education and Sustainable Development, Naples, Italy; 9University of Florence, Endocrinology Unit, “Mario Serio“ Department of Experimental and Clinical Biomedical Sciences, Florence, Italy
Background: Since the preliminary epidemiological data concerning the coronavirus disease 2019 (COVID-19) has been availabe, clear sex disparity has been evident, with males, although not more frequently affected, often experiencing worse outcomes when compared to women. The short and long term andrological effects of coronavirus disease 2019 (COVID-19) have not been clarified. The aim of the present study is to systematically review and meta-analyze all available data regarding possible short- and long-term andrological effects of COVID-19. In addition, information regarding the safety of the COVID-19 vaccines on sperm quality was investigated.
Methods: All prospective and retrospective observational studies reporting information on severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) mRNA semen and male genitalia tract detection, as well as those reporting data on semen analysis and hormonal parameters in infected/recovered patients without any arbitrary restriction were included.
Results: Out of 204 retrieved articles, 35 were considered, including 2.092 patients and 1.138 controls with a mean age of 44.1±12.6 years, and mean follow up 24.3±18.9 days. SARS-CoV-2 mRNA can be localized in male genitalia tracts during the acute phase of the disease; mean crude detection rate (DR) was 8[5;12]%. Meta-regression analysis showed that DR was not influenced by patient age or by disease severity or associated morbidities. DR was significantly higher in those studies assessing the viral mRNA presence in the semen less than 11 days after the diagnosis (P=0.02). When all studies were considered, COVID-19 was associated with a significant reduction of total sperm count, sperm concentration and total sperm motility, whereas no difference in sperm morphology or progressive motility was observed. Moreover, SARS-CoV2 infected patients were characterized by reduced total T levels, whereas no difference in either LH or FSH levels was observed. Sensitivity analyses confirmed the negative effects of SARS-CoV2 infection on T levels only for those studies that included patients in the acute phase (mean difference in total T levels -2.19 [-7.08;-1.20] nmol/l;P=0.01).
Conclusions: COVID-19 can result in short-term impaired sperm and T production. Available data cannot clarify long-term andrological effects. Low T observed in the acute phase of the disease is associated with an increased risk of being admitted to the Intensive Care Unit or death. The use of mRNA COVID-19 vaccines does not seem to affect sperm quality.
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