COVID-19患者SARS-CoV-2感染前后精液质量参数变化的meta分析

Changes of Semen Quality Parameters before and after SARS-CoV-2Infection in Patients with COVID-19:A Meta-Analysis

目的分析新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)患者严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染前后精液质量参数的变化。方法计算机检索PubMed,Embase,中国知网、万方和维普数据库,筛选有关COVID-19患者SARS-CoV-2感染前后精液质量参数变化的文献,检索时间为2019年12月~2022年8月5日。文献质量采用NOS评分。统计分析采用StataSE15.0软件,根据SARSCoV-2感染后精液检测时间进行亚组分析、敏感度分析评估结果的稳定性。结果纳入6篇COVID-19患者SARSCoV-2感染前后的自身对照文献,样本量为21~100例。SARS-CoV-2感染后精液质量参数与感染前相比,总活动精子率[SMD=-0.73,95%CI(-1.16~-0.30)]和前向运动精子率[SMD=-0.52,95%CI(-0.87~-0.17)]下降,差异均有统计学意义(Z=-3.356,-2.932,P=0.001,0.003)。亚组分析显示,SARS-CoV-2感染三个月后精液质量参数与感染前相比,精液量[SMD=-0.15,95%CI(-0.70~0.40)]、精子浓度[SMD=-0.15,95%CI(-0.43~0.13)]、总活动精子率[SMD=-0.85,95%CI(-1.87~0.18)]和前向运动精子率[SMD=-0.48,95%CI(-1.13~0.17)]差异均无统计学意义(Z=-1.622~-0.522,均P>0.05)。敏感度分析精液参数结果稳定。结论初步研究发现COVID-19患者精液质量短期内可能存在不良影响,三个月后可以恢复。

Objective To analyze the changes insemen quality parameters in patients with coronavirus disease 2019(COVID-19)before and after severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods PubMed,Embase,China National Knowledge Infrastructure,Wanfang and VIP databases were searched by computer to screen the literature on the changes in semen quality parameters before and after SARS-CoV-2 infection in patients with COVID-19 from December 2019 to August 5,2022.The quality of the literature was scored by NOS.Statistical analysis was performed using StataSE15.0software.Subgroup analysis was performed according to the semen testing time after SARS-CoV-2 infection,and sensitivity analysis was performed to assess the stability of the results.Results Six self-control papers of COVID-19 patients before and after SARS-CoV-2 infection were included,with sample sizes ranging from 21 to 100 cases.Semen quality parameters after SARS-CoV-2 infection decreased in total motile sperm rate[SMD=-0.73,95%CI(-1.16~-0.30)]and forward motile sperm rate[SMD=-0.52,95%CI(-0.87~-0.17)]compared with pre-infection,the differences were statistically significant(Z=-3.356,-2.932,P=0.001,0.003).Subgroup analysis showed that the semen volume[SMD=-0.15,95%CI(-0.70~0.40)],sperm concentration[SMD=-0.15,95%CI(-0.43~0.13)],total motile sperm rate[SMD=-0.85,95%CI(-1.87~0.18)]and forward motile sperm rate[SMD=-0.48,95%CI(-1.13~0.17)]were not significantly different(Z=-1.622~-0.522,all P>0.05)after 3 months compared to those before SARS-CoV-2 infection.Sensitivity analysis of semen parameters showed stable results.Conclusion Preliminary studies found that sperm quality in COVID-19 patients would be adversely affected in the short term and can recover after 3 months.