ABSTRACT
OBJECTIVE: To evaluate the effect of COVID-19 in sperm cryopreservation processes, including functional parameters evaluated pre-cryopreservation and post-thaw, and to compare post-thaw results from COVID-19 patients to samples from others systemic and andrological Disease MATERIALS AND METHODS: In this cross-sectional study, 37 semen samples of male patients aged 18 to 45 years at Division of Urology, Department of Surgery, Hospital das Clinicas of the University of Sao Paulo or at Androscience- Science and Innovation Center in Andrology, High-Complex Clinical and Research Andrology Laboratory, were initially recruited from April 2020 to April 2021. Patients were categorized as acute COVID-19 (n=15), confirmed by RT-PCR (COVID-19 group), and healthy individuals with normozoospermic semen samples (n=22;Control group). Were evaluated seminal parameters, cryosurvival rates (%), mitochondrial activity (%;3,30 -diaminobenzidine stain), reactive oxygen species levels (ROS;chemiluminescent technique) and DNA fragmentation (%;SCSA method) in precryopreservation and post-thaw samples. Samples were cryopreserved by the slow freezing technique. A complementary retrospective study was performed comparing post-thawed samples from COVID-19 group with data from patients with others male diseases: Male infertility (n=35);Severe infertility (n=62), caused severe oligozoospermia, grade 3 varicocele, gonadal dysgenesis, testicular nodule, testicular hypotrophy;testicular cancer (n=55);and other malignant diseases (leukemia, lymphoma, sarcoma, multiple myeloma;n=30). Was used T-test to statistical analysis (p<0.05). RESULTS: Macroscopy analysis of COVID-group revealed abnormal viscosity in 53.33%, semen volume = 4.50 ± 1.72 ml and pH = 8.13 ± 0.23. COVID-19 fresh samples demonstrated mean of progressive motility = 29.07±16.83%, sperm morphology = 2.07±1.58%, and DNA fragmentation index = 42.91±33.38%. Cryopreservation decreased progressive motility (to 5.39±7.92%;p=0.02), sperm vitality (70.46±8.50 vs. 72.20±23.27;p=0.042) and ROS (0.516±0.978 vs. 4.393±9.956 x 104 cpm;p=0.018). When we compared with cryopreserved normozoospermic samples, there was observed a significant difference in HDS (p=0.002). Cryosurvival rate from COVID-19 samples was 19.93;19.71%, and had significant difference when compared with severe infertility (40.16;31.05%;p=0.003), and other malignant diseases (53.14;28.55%, <0.001). CONCLUSIONS: Seminal samples from patients with COVID-19 showed reduced fertile potential, especially when compared to the reference values. In the comparisons performed with samples from patients with different andrological diagnoses, common in the specialized andrology laboratory routine, we can suggest that samples from patients with the acute form of COVID-19 had the worst quality, with low cryosurvival rates. This information contribute to the conduct of these patients during assisted reproduction routines and preservation of male fertility. IMPACT STATEMENT: It will contribute to conducts in the cryopreservation of sperm in patients with acute COVID-19.
ABSTRACT
Background: Idiopathic inflammatory myopathies are a heterogeneous group of pathological conditions characterized by muscle inflammation, and sometimes by inflammatory involvement of other organs, such as skin (in dermatomyositis) and lungs (pulmonary interstitial disease). Description of the case: 54-year-old woman, turns to the Emergency Room of Miulli Hospital in March 2021 for worsening dyspnea. In medical history: previous recent SARS-CoV-2 infection. She is admitted to Medicine Unit, where the characteristic signs and symptoms of myositis were objected: myasthenia affecting the proximal muscles, myalgias, plantar desquamation of the feet (climber's foot) and fingers (mechanic's hands), Gottron's papules. There are also: pericardial effusion, signs of pulmonary hypertension on echocardiogram, consolidating pulmonary parenchymal changes with fibrotic evolution on HR chest CT. She is transferred to the Rheumatology Unit of the Policlinico Di Bari to perform specific autoantibody panel (positivity of ANA, anti Jo- 1, anti Ro52), electromyography (signs of myogenic suffering), MRI of the thighs (hypotrophy and adipose replacement of the muscles of the posterior lodge) and muscle biopsy, indicative of muscle inflammation. Therapy with steroid boluses and cyclosporine 5mg/kg/day, shows quick effectiveness, and she is discharged with the diagnosis of antisynthetase syndrome. Conclusions: The diagnosis of antisynthetase syndrome is not always easy, due to the clinical heterogeneity of the disease and the need for specific instrumental and laboratory tests.