新型冠状病毒对睾丸功能的影响

Effects of SARS-CoV-2 on testicular function

目的:回顾性分析新型冠状病毒肺炎(COVID-19)患者男性生殖系统症状与体征,研究新型冠状病毒(SARS-CoV-2)在精液中检出情况,探讨SARS-CoV-2对睾丸功能的影响。方法:收集2020年1—3月武汉大学人民医院COVID-19确诊男性患者112例的一般情况、症状及体征等病历资料,收集适龄COVID-19男性患者精液SARS-CoV-2 RNA检测结果,利用HPA在线数据库检索并分析ACE2蛋白及RNA在人类组织器官的分布情况,评估SARS-CoV-2对睾丸功能的影响。结果:HPA在线数据库分析显示,ACE2蛋白及RNA在睾丸组织高表达。112例男性COVID-19患者中,3例(2.7%)重症患者出现睾丸坠胀,其余患者均未出现男性生殖系统异常症状及体征。17例有生育需求的男性患者,精液SARS-CoV-2 RNA检测均为阴性。结论:生物信息学分析提示SARS-CoV-2对睾丸功能有潜在损伤,但目前并无证据显示COVID-19患者出现疾病相关的男性生殖系统异常症状与体征,也未在COVID-19患者精液中检出SARS-CoV-2 RNA。SARS-CoV-2对睾丸功能的远期影响还需进一步评估。

Objective:To describe the clinical characteristics of the male reproductive system of COVID-19 patients and to explore the presence of SARS-CoV-2 in semen.Methods:Case series of 112 male patients with confirmed COVID-19 who were admitted to Renmin Hospital of Wuhan University from January to March,2020.Demographic data,symptoms and signs related to the male reproductive system,throat swabs and semen samples were collected and analyzed.SARS-CoV-2 RNA levels were measured in throat swab and semen samples.The organ distribution of ACE2 mRNA and protein in human tissue on HPA database were investigated.Results:The HPA dataset revealed relatively high levels of ACE2 protein and RNA expression in testis.A total of 3 severe COVID-19 patients(2.7%)presented with orchidoptosis,while no patient experienced other symptoms or signs related to the male reproductive system.The analysis of SARS-CoV-2 RNA in semen included 17 patients with fertility needs.In the semen SARS-CoV-2 analysis,all 17 patients were negative for the N gene and ORF1ab gene.Conclusion:The online datasets indicated the potential impairment of the testicular function by SARS-CoV-2.However,this study suggestes that male patients have few reproductive symptoms and signs,and SARS-CoV-2 was not present in the semen of patients with confirmed CO-VID-19.In view of the potential impairment,the long-term follow-up for male COVID-19 patients with fertility needs is of great significance.