Metabolic, Oxidative and Psychological Stress as Mediators of the Effect of COVID-19 on Male Infertility: A Literature Review

Abstract

Over 300 million patients with coronavirus disease 2019 (COVID-19) have been reported worldwide since the outbreak of the pandemic in Wuhan, Hubei Province, China. COVID-19 is induced by the acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The effect of SARS-CoV-2 infection on the male reproductive system is unclear. The aim of this review is to assess the effect of SARS-CoV-2 infection on male fertility and the impact of possible mediators, such as metabolic, oxidative and psychological stress. SARS-CoV-2 infection aggravates metabolic stress and directly or indirectly affects male fertility by reducing seminal health. In addition, SARS-CoV-2 infection leads to excessive production of reactive oxygen species (ROS) and increased psychological distress. These data suggest that SARS-CoV-2 infection reduces male fertility, possibly by means of metabolic, oxidative and psychological stress. Therefore, among other consequences, the possibility of COVID-19-induced male infertility should not be neglected.

Keywords: COVID-19; male infertility; metabolic stress; oxidative stress; psychological stress.

Figure 1

The impact of COVID-19 on male reproduction (via effects on testosterone secretion or semen parameters) through oxidative, metabolic and psychological stress mediators.

Figure 2

The distribution of angiotensin-converting enzyme-2 receptors (ACE2r) throughout the male body. Ιn red scale, the 5 organs (starting with small intestine and testes) with the widest distribution of ACE2r (Ref. [74]). A large presence of ACE2r is also found in adipose tissue, the breast and colon (not shown).