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Study question Can be the SARS-CoV-2 present in human semen samples from patients infected with COVID-19? Summary answer Our research confirms the presence of SARS-CoV-2 in human ejaculate. What is known already In December 2019 WHO was informed of cases of pneumonia of unknown etiology. This was the beginning of a global pandemic that we are suffering still. COVID-19 disease may damage the male reproductive system. The issue of the presence of SARS-CoV-2 in human semen has been addressed in many studies. Most of them concluded that this virus is not present in human semen. However, until now four groups have reported the presence of SASR-CoV-2. It is quite clear that there is an important controversy about the presence of this virus in semen. Further research is needed to clarify this issue. Study design, size, duration Prospective and experimental cohort study to evaluate the presence of SARS-CoV-2 in human semen. Men, COVID-19 disease confirmed, were asked to donate semen sample from July 2020 to March 2021. The patients were recruited with written informed consent. Explicit instructions were given to the correct collection of samples. Participants were interviewed to confirm that collection and transport took place under hygienic conditions. Semen samples were accepted only when instructions were adequately followed. Participants/materials, setting, methods Semen samples were obtained from 50 men (aged 20-51 years) who were diagnosed with qRT-PCR-COVID19 positive (Ct < 40) in nasopharyngeal swab. Patients were closely followed while in hospital or at home. Each semen sample was divided in three aliquots (1 milliliter each) in order to: 1. Perform a spermiogram, 2. Evaluate SARS-CoV-2 with qRT-PCR-COVID19 and 3. Freeze for later use, if necessary. Patients were asked to provide a new specimen if PCR in semen was positive. Main results and the role of chance Patients included in the study showed different types of pneumonia: mild/moderate (N = 46) and severe (N = 6). Patients with severe symptoms had to be placed in intensive care unit. Average time from admission to hospital to sperm collection was 5,8 days. The study did not find any correlation between fresh semen parameters (volume, pH, count and motility) and severity of illness. SARS-CoV-2 was detected in one of fifty (1/50) fresh semen samples. The patient with SARS-CoV-2 in semen had mild symptoms of pneumonia (fever, headache and muscle pain). The patient was asked about how the semen sample was collected. Standards of hygiene during semen collection were confirmed by patient. Presence of SARS-CoV-2 in patient’s semen sample was verified. Limitations, reasons for caution It is possible (though unlikely) that semen sample collection and transportation were incorrect or unhygienic (it was refuted by patient). Besides that, we cannot exclude a false positive in PCR analysis. Although this test has very high specificity with a practical absence of false positives. Wider implications of the findings Although it is evident that the presence of SARS-CoV-2 in human semen is extremely rare, at least four studies confirm this view. In any case the presence of this virus in human semen samples cannot be completely ruled out, on the contrary, further studies are required to confirm this presence. Trial registration number 2020-310-1
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The human effect on air quality in cities and the evolution of air pollution is obvious, due to economic activity, vehicle traffic, etc. The situation created indirectly by COVID-19, has caused many countries to impose during certain periods restriction of movement and stoppage of economic activities, which has allowed us to observe the instant effect that occurs on the air quality in cities. This article discusses what the observed effect has been, focusing on the early moments of the pandemic (January 2020 to March 2020), with an analysis of the situation from its origin in China to its arrival in Europe and more specifically the situation created in Spain. After the analysis of the situation, it can be seen the large reduction of pollutants in the air of different cities, and in particular in Spain, which came to reduce about 80%. All this leads us to the observation of how human activity can greatly influence air pollution. © 2020, Universidad Politecnica de Valencia. All rights reserved.
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Introduction and objective: Despite advances in treatment, patients with acute myocardial infarction (AMI) still exhibit unfavorable short- and long-term prognoses. In addition, there is scant evidence about the clinical outcomes of patients with AMI and coronavirus disease 2019 (COVID-19). The objective of this study was to describe the clinical presentation, complications, and risk factors for mortality in patients admitted for AMI during the COVID-19 pandemic. Methods: This prospective, multicenter, cohort study included all consecutive patients with AMI who underwent coronary angiography in a 30-day period corresponding chronologically with the COVID-19 outbreak (March 15 to April 15, 2020). Clinical presentations and outcomes were compared between COVID-19 and non-COVID-19 patients. The effect of COVID-19 on mortality was assessed by propensity score matching and with a multivariate logistic regression model. Results: In total, 187 patients were admitted for AMI, 111 with ST-segment elevation AMI and 76 with nonST-segment elevation AMI. Of these, 32 (17%) were diagnosed with COVID-19. GRACE score, Killip-Kimball classification, and several inflammatory markers were significantly higher in COVID-19-positive patients. Total and cardiovascular mortality were also significantly higher in COVID-19-positive patients (25% vs 3.8% [P < .001] and 15.2% vs 1.8% [P = .001], respectively). GRACE score > 140 (OR, 23.45;95%CI, 2.52-62.51;P = .005) and COVID-19 (OR, 6.61;95%CI, 1.82-24.43;P = .02) were independent predictors of in-hospital death. Conclusions: During this pandemic, a high GRACE score and COVID-19 were independent risk factors associated with higher in-hospital mortality. (C) 2020 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.