Coronavirus News: Could COVID-19 Create A Whole Generation Of ‘Virally-Castrated’ Eunuchs? Study Confirms Male Fertility Is At Risk!

Coronavirus News: A Turkish researcher, Dr Cemile Seymen from the Gazi University Institute of Health Sciences, Ankara-Turkey has warned based on his study findings that the COVID-91 disease is able to negatively affect male reproductive health and fertility.


 
The study findings were published in the peer reviewed journal of Medical Virology. https://onlinelibrary.wiley.com/doi/10.1002/jmv.26667
 
The COVID-19 outbreak has become a major pandemic threat worldwide. According to the existing clinical data, the SARS-CoV-2 coronavirus not only causes respiratory diseases and affects the lungs but also induces the histopathological or functional changes in various organs like the testis and also the male genital tract. The Renin‐Angiotensin System (RAS), also ACE 2 and TMPRSS2 play an important role in a cellular entry for SARS‐CoV‐2. Because of the male genital system presents high ACE 2 expression, the importance of this pathway increases in COVID‐19 cases. Due to the COVID‐19 pandemic affects the male genital system in direct or indirect ways and shows a negative impact on male reproduction, this new study focuses on the possible mechanisms underlying the damage caused by COVID‐19 to the testis and also other components of the male genital tract.
 
These findings are nothing new as Thailand Medical news was already warning on this development as early as February. https://www.thailandmedical.news/news/breaking-news!-latest-research-published-by-chinese-scientists-say-coronavirus-might-render-certain-male-patients-infertile
 
https://www.thailandmedical.news/news/breaking-male-infertility-research-shows-that-sars-cov-2-coronavirus-may-indirectly-cause-testicular-damage-in-male-covid-19-patients-and-also-orchiti
 
https://www.thailandmedical.news/news/sars-cov-2-news-ultrasound-diagnostic-imaging-shows-that-sars-cov-2-causes-acute-testicular-infection-in-a-high-proportion-of-male-covid-19-patients
 
The new research paper discusses the effects of the SARS-CoV-2 coronavirus may have on male fertility and summarizes study findings showing how the infection can negatively affect male reproductive health.
 
Dr Seymen says further studies are needed to investigate the roles that the host cell proteins angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) may play in infection since both of these proteins, which are involved in viral entry, are highly expressed in the male reproductive system.
 
To date very little data are available on the effects of COVID-19 on male fertility. Dr Seymen told Thailand Medical News, "There is a very limited number of data abo ut the effects of COVID-19 on male fertility, so it has become an important topic for researchers."
 
In order to gain viral entry, SARS-CoV-2 uses a surface structure called the spike protein to bind to the ACE2 receptor present on host cells.
 
A research published earlier this year showed that ACE2 messenger RNA was expressed in both germ and somatic cells of the testis. Other studies have found that ACE2 is expressed in spermatogonia, Leydig cells, and Sertoli cells. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361928/
 
https://pubmed.ncbi.nlm.nih.gov/32283711/
 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314215/
 
Significantly one study that used electron microscopy to examine post-mortem tissues from the testes of twelve COVID-19 patients demonstrated swelling, vacuolation, and cytoplasmic dilution in the Sertoli cells and a reduction in the number of Leydig cells, compared with patients who did not have COVID-19.
https://www.sciencedirect.com/science/article/pii/S2405456920301449
 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306201/
 
Certain studies have also demonstrated increased levels of the autophagy receptor SQSTM1 in cells infected with SARS-CoV-2, indicating a fall in autophagy flux. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347466/
 
Dr Seymen writes, "As a result, SARS-CoV-2 may cause male reproductive disorders by regulating the level of autophagy in male germ cells.”
 
Scientists have also proposed that an increase in testicular temperature as an indirect effect of inflammation has negative impacts on the testes among COVID-19 patients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306201/
 
Dr Seymen also discusses the role that TMPRSS2 may play in SARS-CoV-2 infection of the prostate.
 
A particular past research found that this enzyme, which cleaves the spike protein in preparation for virus and host membrane fusion, is highly expressed in the prostate's epithelium. https://europepmc.org/article/med/32533891
 
Interestingly, this gland secretes prostate fluid, one of the main components of the seminal fluid. Muscles within the gland are responsible for pushing the seminal fluid through the urethra during ejaculation.
 
Hence the high expression of TMPRSS2 within the prostate could increase the likelihood of SARS-CoV-2 infection in this gland, which may affect its ability to secrete these fluids, says Dr Seymen.
 
Dr Seymen also points out that SARS-CoV-2 could also exert negative impacts on male fertility indirectly, through mechanisms involving the nervous system.
 
For instance, most viruses permeate the blood-brain barrier and reports have shown that glial cells and neurons also express ACE2 receptors, potentially making them a target for neuronal death induced by SARS-CoV-2.
 
The central nervous system plays a critical role in endocrine control and spermatogenesis. Neurons in the hypothalamus secrete gonadotropin-releasing hormone (GnRH), for example, which triggers the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361071/
 
It has been found that low levels of GnRH results in decreased FSH and LH, which in turn impacts the function of Sertoli cells and Leydig cells.
 
Dr Seymen also points out that depression and anxiety (which many people are experiencing during the current pandemic) are associated with increased levels of cortisol and prolactin, as well as a lower sperm count and semen volume, all of which have been shown to contribute to sexual dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192111/
 
Dr Seymen says that taken together, these study findings suggest that the COVID-19 pandemic affects the male reproductive system in both direct and indirect ways.
 
Dr Seymen concluded, "Additional studies are necessary to answer all the questions and further investigations are warranted, but ACE2 and TMPRSS2 play an important role in the cellular entry of SARS-CoV-2. Because the male genital system presents high ACE 2 expression, the importance of this pathway increases in COVID-19 cases."
 
It is also highly recommended that all male COVID-19 patients who are deemed “recovered” to have frequent health screenings with an urologist and fertility specialist to check on their health status.
 
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