BREAKING COVID-19 NEWS! Argentinian Scientists Warn That Asymptomatic SARS-CoV-2 Infections Can Lead To Persistent Oligonecrozoospermia In Men!

COVID-19 News: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has been a global health crisis since its emergence. While its primary impact has been on respiratory health, scientists and researchers have been uncovering various other consequences of the virus on different systems of the body. One emerging concern is its potential impact on male reproductive health and fertility.


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 In a groundbreaking report from researchers at Universidad Nacional de Córdoba-Argentina, OVUM- Centro de Medicina Reproductiva, Fetal y Cirugía Ambulatoria-Argentina, and Fundación Urológica Córdoba para la Docencia e Investigación Médica (FUCDIM)- Argentina, a case of asymptomatic SARS-CoV-2 infection leading to persistent oligonecrozoospermia in a previously healthy man has been documented.
 
Understanding Oligonecrozoospermia and SARS-CoV-2
Before delving into the specifics of the case, it's crucial to understand the terms involved. Oligozoospermia is a condition characterized by a sperm count below the lower reference limit, while necrozoospermia refers to the absence of living sperm in the ejaculate. When these two conditions coexist, it's termed oligonecrozoospermia, a severe impairment of male fertility.
 
COVID-19 has been shown to affect multiple bodily systems, with severe cases often impacting the respiratory, cardiovascular, central nervous, and gastrointestinal systems. However, its effects on male reproductive health and fertility have been a topic of ongoing research, with conflicting data reported. Furthermore, the long-term consequences of SARS-CoV-2 infection remain poorly understood.
 
In this report, the study team presented the case of a 42-year-old man with no known health issues and normal baseline semen quality. This individual experienced an asymptomatic SARS-CoV-2 infection, and shortly afterward, he developed a sudden decline in sperm quality, eventually leading to persistent severe oligonecrozoospermia. Importantly, this deterioration occurred in the absence of other factors such as urogenital infections, hormonal imbalances, obstructions, medications, smoking, or exposure to toxins, pollutants, radiation, or high temperatures.
 
This case serves as a significant addition to the growing body of knowledge regarding the potential long-term consequences of SARS-CoV-2 infection on male fertility. With over 600 million reported cases of COVID-19 and more than 6 million fatalities globally, understanding the virus's impact on various systems, including reproductive health, is of paramount importance.
 
The Global Impact of COVID-19
Since the emergence of COVID-19 in late 2019, the world has grappled with its devastating effects. By January 2023, more than 680 million cases had been reported, resulting in over 6.7 million deaths. While the virus affects individuals of all genders, it has been notably harsher on males, leading to more severe symptoms and higher mortality rates. The spectrum of COVID-19 manifestations is wide, ranging from asymptomatic infections to fatal cases. Additionally, many individuals experience lingering symptoms long after their initial infection, a condition referred to as long COVID-19.
 
Long COVID-19 encompasses a range of ongoing or recurrent health issues that persist for more than four weeks after the initial SARS-CoV-2 infection. This syndrome has been observed in individuals across different age groups, particularly those aged 36–50, who may have initially experienced mild or asymptomatic infections. While current data suggests that over 65 million people worldwide are dealing with long COVID-19 consequences, the actual prevalence is likely even higher due to underreporting and subclinical cases.
 
SARS-CoV-2 and Male Fertility
One area of concern in the context of COVID-19 is its potential impact on male fertility. Emerging research has shown that SARS-CoV-2 infection can affect sperm quality and may have long-term consequences on male reproductive potential. Studies have reported an inverse association between COVID-19 infection and sperm quality parameters, including volume, concentration, motility, and viability, with the severity of these alterations correlating with the severity of the disease.
 
Numerous past COVID-19 News reports have already covered about how SARS-CoV-2 can cause fertility issues in men.
 
https://www.thailandmedical.news/news/bad-news-belgium-study-finds-that-males-who-had-covid-19-will-have-low-sperm-and-motility-levels-for-months-good-news-they-will-not-turn-into-drag-que
 
https://www.thailandmedical.news/news/breaking-columbia-university-study-confirms-presence-of-sars-cov-2-virus-in-human-semen-along-with-infected-males-having-low-sperm-count
 
https://www.thailandmedical.news/news/covid-19-news-study-unveils-the-impact-of-inflammatory-cytokines-on-testicular-cells-in-covid-19-male-fertility-at-risk
 
https://www.thailandmedical.news/news/breaking-news-covid-19-infections-results-in-various-autoantibodies-that-target-proteins-associated-with-the-male-fertility
 
https://www.thailandmedical.news/news/covid-19-news-groundbreaking-danish-study-shows-than-men-with-mild-covid-19-infections-still-ended-up-with-impaired-testicular-function
 
https://www.thailandmedical.news/news/brazilian-study-reveals-surprising-link-between-sars-cov-2-nucleocapsid-protein-and-lower-testosterone-levels
 
https://www.thailandmedical.news/news/who-warns-that-infertility-rates-are-rising-with-17-5-percent-of-individuals-globally-infertile-covid-19-at-play
 
https://www.thailandmedical.news/news/breaking-study-identifies-human-proteins-targeted-by-covid-19-induced-autoantibodies-and-also-alarmingly-discovers-male-fertility-is-greatly-at-risk
 
https://www.thailandmedical.news/news/coronavirus-news-could-covid-19-create-a-whole-generation-of-virally-castrated-eunuchs-study-confirms-male-fertility-is-at-risk
 
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/breaking-news!-latest-research-published-by-chinese-scientists-say-coronavirus-might-render-certain-male-patients-infertile
 
A recent meta-analysis confirmed that even mild or asymptomatic cases of COVID-19 can have adverse effects on sperm quality, leading to reductions in sperm concentration, total sperm count, sperm motility, and normal sperm morphology. However, discrepancies in reported findings can be attributed to non-standardized diagnostic criteria, varying laboratory methods, and different research settings. Additionally, the absence of pre-infection semen quality data and a lack of long-term cohort studies leave many questions unanswered regarding the long-term impact of SARS-CoV-2 infection on male fertility.
 
The Case Presentation
The report focuses on the case of a 42-year-old man with a history of normal semen quality who sought medical attention with his partner due to primary infertility. Prior to the asymptomatic SARS-CoV-2 infection, the patient had consistently exhibited good sperm quality over seven years of monitoring. However, following the infection, the patient experienced a rapid decline in sperm quality, progressing from oligoasthenozoospermia to azoospermia within a few months.
 
Notably, magnetic resonance imaging (MRI) of the pelvis and scrotum revealed no obstructions or abnormalities in the urogenital organs, including the testicles, epididymides, vas deferens, seminal vesicles, and the prostate. Additionally, a comprehensive assessment ruled out urogenital infections, hormonal imbalances, medication use, smoking, or exposure to toxins, pollutants, radiation, or high temperatures as potential causes for the decline in sperm quality.
 
Subsequent analyses revealed persistent oligoasthenozoospermia and necrozoospermia, accompanied by elevated levels of inflammatory markers TNF, IL-1β, and IL-6 in semen. The patient also exhibited significantly increased levels of reactive oxygen species (ROS) production in viable sperm, indicating oxidative stress as a contributing factor to the observed necrozoospermia. Despite treatment with antioxidant supplementation, including vitamin C and E, the patient's sperm quality did not improve.
 
Remarkably, the patient's sperm quality continued to deteriorate, ultimately resulting in persistent oligonecrozoospermia nearly two years after the asymptomatic SARS-CoV-2 infection.
 
Discussion and Possible Mechanisms
While the global impact of COVID-19 is well-documented, its effects on male fertility are still under investigation. Several theories have been proposed to explain the observed decline in sperm quality following SARS-CoV-2 infection. These include direct viral effects on testicular function, inflammation, and oxidative stress.
 
Histopathological alterations in the testes of COVID-19 patients have been reported, including thinning of seminiferous tubules, loss of germ cells, and increased apoptosis. While the virus primarily uses angiotensin-converting enzyme 2 (ACE2) as a receptor, its impact on testicular ACE2 expression remains debated. Furthermore, the absence of viral RNA or proteins in semen and the lack of documented sexual transmission of the virus suggest that direct testicular infection may not be a major contributing factor.
 
Instead, inflammation and oxidative stress induced by COVID-19 may play a more significant role in impairing spermatogenesis. Inflammatory cytokines, particularly IL-6, TNF, and IL-1β, have been detected in semen of COVID-19 patients and are known to trigger reactive oxygen species production and apoptosis in sperm. Additionally, reports suggest that SARS-CoV-2 may induce senescence in testicular cells through the MAPK pathway, potentially leading to impaired spermatogenesis.
 
Conclusion and Patient Perspective
This case report highlights a unique and concerning consequence of asymptomatic SARS-CoV-2 infection - the development of persistent severe oligonecrozoospermia in an otherwise healthy individual. Despite treatment attempts, the patient's sperm quality has not recovered nearly two years after infection. This case adds to the growing body of evidence suggesting that SARS-CoV-2 infection may have long-lasting detrimental effects on male fertility.
Understanding the full scope of the virus's impact on various systems, including the reproductive system, is crucial for providing comprehensive medical care.
 
Further research is needed, including larger cohort studies with pre-infection semen quality data, to confirm and expand upon these findings.
 
As for the patient, he and his partner have decided to pursue assisted reproduction using donated oocytes and sperm due to his persistent severe oligonecrozoospermia. Regular medical follow-ups will continue to monitor his condition.
 
In conclusion, the case presented here serves as a stark reminder of the complexities and potential long-term consequences of COVID-19, urging us to delve deeper into its impact on human health, including male fertility.
 
The study findings were published in the peer reviewed journal: Heliyon.
https://www.cell.com/heliyon/fulltext/S2405-8440(23)07548-5
 
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