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Meta-Analysis
. 2022 Dec;45(12):2207-2219.
doi: 10.1007/s40618-022-01801-x. Epub 2022 May 9.

Andrological effects of SARS-Cov-2 infection: a systematic review and meta-analysis

G Corona  1 , W Vena  2 , A Pizzocaro  2 , F Pallotti  3 , D Paoli  3 , G Rastrelli  4 , E Baldi  4 , N Cilloni  5 , M Gacci  6 , F Semeraro  5 , A Salonia  7   8 , S Minhas  9 , R Pivonello  10   11 , A Sforza  1 , L Vignozzi  4 , A M Isidori  3 , A Lenzi  3 , M Maggi  12 , F Lombardo  3
Affiliations
Meta-Analysis

Andrological effects of SARS-Cov-2 infection: a systematic review and meta-analysis

G Corona et al. J Endocrinol Invest. 2022 Dec.

Abstract

Purpose: The short- and long-term andrological effects of coronavirus disease 2019 (COVID-19) have not been clarified. Our aim is to evaluate the available evidence regarding possible andrological consequences of COVID-19 either on seminal or hormonal parameters. The safety of the COVID-19 vaccines in terms of sperm quality was also investigated.

Methods: All prospective and retrospective observational studies reporting information on severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) mRNA semen and male genitalia tract detection (n = 19), as well as those reporting data on semen analysis (n = 5) and hormonal parameters (n = 11) in infected/recovered patients without any arbitrary restriction were included.

Results: Out of 204 retrieved articles, 35 were considered, including 2092 patients and 1138 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. 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 two available studies showed that the use of mRNA COVID-19 vaccines does not affect sperm quality.

Conclusions: The results of our analysis clearly suggest that each patient recovering from COVID-19 should be monitored to rule out sperm and T abnormalities. The specific contribution of reduced T levels during the acute phase of the infection needs to be better clarified.

Keywords: COVID-19; Hypogonadism; SARS-CoV-2; Sperm; Testosterone; Vaccination.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Male genitalia tract mRNA SARS-Cov-2 detection rate (%)
Fig. 2
Fig. 2
Influence of age (A), disease severity (B), arterial hypertension (C), diabetes mellitus (D), and time from diagnosis (E) on male genitalia tract mRNA COVID-19 detection rate. The size of the circles indicates sample dimension
Fig. 3
Fig. 3
Semen parameters in COVID-19 subjects as compared to controls: total sperm count (A), sperm concentration (B), sperm total motility (C), semen volume (D)
Fig. 4
Fig. 4
Hormonal parameters in COVID-19 subjects as compared to controls: total testosterone (A), follicular stimulating hormone (FSH; B), luteinizing hormone (LH; C)
Fig. 5
Fig. 5
Fully adjusted risk to be admitted to Intensive Care Unit (A) or to die (B) due to COVID-19 according to low baseline T levels
See this image and copyright information in PMC

References

    1. Corona G, Pizzocaro A, Vena W, Rastrelli G, Semeraro F, Isidori AM, et al. Diabetes is most important cause for mortality in COVID-19 hospitalized patients: systematic review and meta-analysis. Rev Endocr Metab Disord. 2021;22(2):275–296. - PMC - PubMed
    1. Salonia A, Corona G, Giwercman A, Maggi M, Minhas S, Nappi RE, et al. SARS-CoV-2, testosterone and frailty in males (PROTEGGIMI): a multidimensional research project. Andrology. 2021;9(1):19–22. - PubMed
    1. Pivonello R, Auriemma RS, Pivonello C, Isidori AM, Corona G, Colao A, et al. Sex disparities in COVID-19 severity and outcome: are men weaker or women stronger? Neuroendocrinology. 2020;111:1066. - PMC - PubMed
    1. Rastrelli G, Di Stasi V, Inglese F, Beccaria M, Garuti M, Di Costanzo D, et al. Low testosterone levels predict clinical adverse outcomes in SARS-CoV-2 pneumonia patients. Andrology. 2021;9(1):88–98. - PMC - PubMed
    1. Salonia A, Pontillo M, Capogrosso P, Gregori S, Tassara M, Boeri L, et al. Severely low testosterone in males with COVID-19: a case-control study. Andrology. 2021;9(4):1043–1052. - PMC - PubMed