Lisco Giuseppe, De Tullio Anna, Matin Maima, Giagulli Vito Angelo, Guastamacchia Edoardo, De Pergola Giovanni, Piazzolla Giuseppina, Triggiani Vincenzo
Interdisciplinary Department of Medicine, School of Medicine, University of Bari "Aldo Moro", Bari, Italy.
Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Magdalenka, Poland.
Andrology. 2024 Dec 31. doi: 10.1111/andr.13830.
Evidence indicates a wide range of andrological alterations in patients with the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection and Coronavirus Disease 2019 (COVID-19).
To provide an update on the andrological effects of SARS-CoV-2 infection and COVID-19.
PubMed/MEDLINE and Institutional websites were searched for randomized clinical trials, non-systematic reviews, systematic reviews, and meta-analyses.
Fifty-four records were included from 2020 to 2024. The most representative paper categories were non-systematic reviews (n = 26) and systematic reviews/meta-analyses (n = 27). One randomized, prospective, phase 2 trial was also included. Eight topics were identified and discussed as follows: short- and long-term seminal changes attributable to SARS-CoV-2 infection or COVID-19; andrological effects of anti-SARS-CoV-2 vaccines; the potential impact of SARS-CoV-2 infection and COVID-19 on male fertility; the relationship between serum testosterone levels and COVID-19 prognosis in men; fertility care during the pandemic; urinary/genital male system tract impairment in SARS-CoV-2 infection and COVID-19; the effect of SARS-CoV-2 infection and COVID-19 on circulating levels of sex steroid hormones; the impact of SARS-CoV-2 and COVID-19 on sexual function and activity.
SARS-CoV-2 can affect the whole testicular function through direct and indirect mechanisms, with a positive relation between the severity of SARS-CoV-2 infection and the level of deterioration of testicular function. Testicular function recovers along with the recovery from the disease. In vitro fertilization techniques ensure similar results in patients with or without previous SARS-CoV-2 infection or COVID-19. Immunization with anti-SARS-CoV-2 vaccines prevents andrological complaints due to naturally occurring infection. Erectile dysfunction and sexual dysfunction are frequently diagnosed in COVID-19 patients due to several contributing factors, including hormonal imbalance and psychosocial complaints related to the pandemic.
有证据表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染和2019冠状病毒病（COVID-19）患者存在广泛的男性生殖系统改变。
提供SARS-CoV-2感染和COVID-19对男性生殖系统影响的最新情况。
在PubMed/MEDLINE和机构网站上检索随机临床试验、非系统评价、系统评价和荟萃分析。
纳入了2020年至2024年的54篇记录。最具代表性的论文类别是非系统评价（n = 26）和系统评价/荟萃分析（n = 27）。还纳入了一项随机、前瞻性2期试验。确定并讨论了八个主题，如下所示：SARS-CoV-2感染或COVID-19导致的短期和长期精液变化；抗SARS-CoV-2疫苗对男性生殖系统的影响；SARS-CoV-2感染和COVID-19对男性生育能力的潜在影响；男性血清睾酮水平与COVID-19预后的关系；疫情期间的生育护理；SARS-CoV-2感染和COVID-19导致的男性泌尿/生殖系统损害；SARS-CoV-2感染和COVID-19对循环性激素水平的影响；SARS-CoV-2和COVID-19对性功能和性行为的影响。
SARS-CoV-2可通过直接和间接机制影响整个睾丸功能，SARS-CoV-2感染的严重程度与睾丸功能恶化程度呈正相关。睾丸功能随疾病康复而恢复。体外受精技术在既往有或无SARS-CoV-2感染或COVID-19的患者中可确保相似的结果。接种抗SARS-CoV-2疫苗可预防自然感染引起的男性生殖系统问题。由于包括激素失衡和与疫情相关的社会心理问题等多种因素，COVID-19患者中经常诊断出勃起功能障碍和性功能障碍。
