ABSTRACT
As COVID-19 infections wreak havoc across the globe, attention has rightly been focused on the vital organ systems (lung, kidney and heart) that are vulnerable to viral attack and contribute to the acute pathology associated with this disease. However, we should not lose sight of the fact that COVID-19 will attack any cell type in the body expressing ACE2 - including human spermatozoa. These cells possess the entire repertoire of receptors (AT1R, AT2R, MAS) and ligand processing enzymes (ACE1 and ACE2) needed to support the angiotensin signalling cascade. The latter not only provides COVID-19 with a foothold on the sperm surface but may also promote integration, given the additional presence of a range of proteases (TMPRSS2, TMPRSS11B, TMPRSS12, furin) capable of promoting viral fusion. This article reviews the roles played by these various cellular constituents in maintaining the vitality of human spermatozoa and their competence for fertilization. The reproductive consequences of a viral attack on these systems, in terms of fertility and the risk of sexual transmission, are currently unknown. However, we should be alive to the possibility that there may be reproductive consequences of COVID-19 infection in young males that go beyond their capacity to survive a viral attack.
Subject(s)
COVID-19/virology , Infertility, Male/virology , SARS-CoV-2/isolation & purification , Sexually Transmitted Diseases, Viral/virology , Spermatozoa/virology , Animals , COVID-19/diagnosis , COVID-19/metabolism , COVID-19/transmission , Humans , Infertility, Male/diagnosis , Infertility, Male/metabolism , Male , Receptors, Virus/metabolism , Risk Assessment , Risk Factors , Sexually Transmitted Diseases, Viral/diagnosis , Sexually Transmitted Diseases, Viral/metabolism , Sexually Transmitted Diseases, Viral/transmission , Spermatozoa/metabolismABSTRACT
Research is needed to understand the presence of the SARS-CoV-2 virus in semen, sexual transmissibility, and impact on sperm quality. Several studies have examined men recovering from COVID-19, but large-scale community-based testing is needed to ascertain the effects on the male reproductive tract, and the potential for prolonged transmission.