Hu Bintao, Liu Kang, Ruan Yajun, Wei Xian, Wu Yue, Feng Huan, Deng Zhiyao, Liu Jihong, Wang Tao
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Transl Androl Urol. 2022 Feb;11(2):159-167. doi: 10.21037/tau-21-922.
The coronavirus disease 2019 (COVID-19) has spread worldwide with alarming levels of spread and severity. The distribution of angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) from bioinformatics evidence, the autopsy report for COVID-19 and the published study on sperm quality indicated COVID-19 could have a negative impact on male fertility. However, whether the negative impact of COVID-19 on male fertility is persistent remains unknown, which requires long-term follow-up investigation.
Semen samples were collected from 36 male COVID-19 patients with a median recovery time of 177.5 days and 45 control subjects. Then, analysis of sperm quality and alterations of total sperm number with recovery time were performed.
There was no significant difference in semen parameters between male recovered patients and control subjects. And the comparisons of semen parameters between first follow-up and second follow-up revealed no significant difference. In addition, we explored the alterations of sperm count with recovery time. It showed that the group with recovery time of ≥120 and <150 days had a significantly lower total sperm number than controls while the other two groups with recovery time of ≥150 days displayed no significance with controls, and total sperm number showed a significant decline after a recovery time of 90 days and an improving trend after a recovery time of about 150 days.
The sperm quality of COVID-19 recovered patients improved after a recovery time of nearly half a year, while the total sperm number showed an improvement after a recovery time of about 150 days. COVID-19 patients should pay close attention to the quality of semen, and might be considered to be given medical interventions if necessary within about two months after recovery, in order to improve the fertility of male patients as soon as possible.
2019年冠状病毒病（COVID-19）已在全球范围内传播，其传播速度和严重程度令人担忧。从生物信息学证据、COVID-19尸检报告以及已发表的关于精子质量的研究来看，血管紧张素转换酶2（ACE2）和跨膜丝氨酸蛋白酶2（TMPRSS2）的分布表明COVID-19可能对男性生育能力产生负面影响。然而，COVID-19对男性生育能力的负面影响是否持续尚不清楚，这需要长期的随访调查。
收集了36例COVID-19男性患者的精液样本，这些患者的中位康复时间为177.5天，同时收集了45例对照者的精液样本。然后，对精子质量以及精子总数随康复时间的变化进行了分析。
康复男性患者与对照者之间的精液参数无显著差异。第一次随访和第二次随访之间的精液参数比较也无显著差异。此外，我们探讨了精子数量随康复时间的变化。结果显示，康复时间≥120天且<150天的组的精子总数显著低于对照组，而康复时间≥150天的其他两组与对照组无显著差异，精子总数在康复90天后显著下降，在康复约150天后呈上升趋势。
COVID-19康复患者的精子质量在康复近半年后有所改善，而精子总数在康复约150天后有所改善。COVID-19患者应密切关注精液质量，康复后约两个月内如有必要可考虑给予医学干预，以便尽快提高男性患者的生育能力。
