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COVID-19 与男性生殖功能:一项前瞻性、纵向队列研究。

COVID-19 and male reproductive function: a prospective, longitudinal cohort study.

机构信息

Department of Exercise Physiology and Sports Therapy, Kugelberg 62, Justus-Liebig-University, Giessen, Germany.

Department of Sports Injuries, Faculty of Physical Education and Sports Sciences, Allameh Tabataba'i University, Tehran, Iran.

出版信息

Reproduction. 2021 Mar;161(3):319-331. doi: 10.1530/REP-20-0382.

Abstract

The existing evidence suggests that the human reproductive system may be potentially vulnerable to COVID-19 infection. However, little is known about the virus-host interaction of COVID-19 in sperm cells. We are the first to address the connection between changes in multiple seminal biomarkers and reproductive function in male patients recovering from COVID-19. In a prospective longitudinal cohort study, seminal ACE2 activity, markers of inflammation and oxidative stress, apoptotic variables, and semen quality parameters were evaluated at 10-day intervals for a maximum follow-up time of 60 days among male patients with laboratory-confirmed COVID-19 (n = 84) and healthy controls (CON; n = 105). At the baseline and the subsequent follow-ups, the COVID-19 group revealed significantly higher levels of seminal plasma ACE2 enzymatic activity, IL-1β, IL-6, IL-8, IL-10, TGF-β, TNF-α, IFN-α, IFN-γ, ROS, caspase-8, caspase-9, and caspase-3 activity as well as lower levels of SOD activity than those in the CON group (P < 0.05). These perturbations tended to persist over time and were correlated with significant impairments in semen volume, progressive motility, sperm morphology, sperm concentration, and the number of spermatozoa. We provide the direct experimental evidence that the male reproductive system could be targeted and damaged by the COVID-19 infection. These findings go beyond our current understanding of the disease, suggesting that the reproductive function of the patients recovering from the disease should be precisely followed and evaluated to detect and avoid more serious reproductive problems in the future, as they may develop a transient state of male subfertility like those with oligoasthenoteratozoospermia.

摘要

现有证据表明,人类生殖系统可能容易受到 COVID-19 感染的影响。然而,人们对 COVID-19 在精子细胞中与宿主的相互作用知之甚少。我们是第一个研究从 COVID-19 中恢复的男性患者的多个精液生物标志物变化与生殖功能之间关系的人。在一项前瞻性纵向队列研究中,我们在 10 天的间隔内评估了 84 例实验室确诊的 COVID-19 男性患者(COVID-19 组)和 105 例健康对照者(CON 组)的精液 ACE2 活性、炎症和氧化应激标志物、凋亡变量和精液质量参数,最长随访时间为 60 天。在基线和随后的随访中,COVID-19 组的精液血浆 ACE2 酶活性、IL-1β、IL-6、IL-8、IL-10、TGF-β、TNF-α、IFN-α、IFN-γ、ROS、caspase-8、caspase-9 和 caspase-3 活性明显高于 CON 组(P < 0.05),而 SOD 活性明显低于 CON 组(P < 0.05)。这些变化随着时间的推移而持续存在,与精液量、前向运动精子比例、精子形态、精子浓度和精子数的显著降低有关。我们提供了直接的实验证据,证明男性生殖系统可能会受到 COVID-19 感染的影响和损害。这些发现超出了我们对该疾病的现有认识,表明应该精确地跟踪和评估从疾病中恢复的患者的生殖功能,以发现和避免未来更严重的生殖问题,因为他们可能会出现短暂的男性生育力低下状态,就像那些患有少弱畸精症的患者一样。

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