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KMID : 1037120230410030538
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The World Journal of Men′s Health
2023 Volume.41 No. 3 p.538 ~ p.557
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Male Reproductive Tract Involvement and Sperm Parameters in SARS-CoV-2 Patients: A Systematic Review and Meta-Analysis
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Yudhistira Pradnyan Kloping
Furqan Hidayatullah
Zakaria Aulia Rahman
Eric Chung
Lukman Hakim
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Abstract
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Purpose : There is a growing concern regarding the impact of SARS-CoV-2 infection on the male reproductive tract due to ACE2 receptor expression, however, its impact remains unclear. We performed this review to evaluate whether SARS-CoV-2 infection affects the male reproductive system.
Materials and Methods : We conducted a search in the Embase, Scopus, and MEDLINE databases, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Eligible studies comprised articles reporting viral RNA presence in semen, sperm parameters, and orchitis or orchiepididymitis occurrence in SARS-CoV-2 patients. Observational studies’ quality was determined using the Newcastle?Ottawa Scale (NOS). Case reports were assessed using the Joanna Briggs Institute (JBI)’s checklist.
Results : A total of 32 relevant articles were included. Viral RNA was found in 7% of infected patients’ semen (95% CI, -0.01 to 0.15) from 3 studies. There were also only 7% of patients with orchitis or orchiepididymitis clinical manifestations (95% CI, 0.05?0.10). The semen volume and concentration were 2.34 mL (95% CI, 1.87?2.81) and 51.73 million/mL (95% CI, 31.60?71.85). The progressive and total motility percentages were 36.11% (95% CI, 28.87?43.35) and 43.07% (95% CI, 28.57?57.57), respectively. The morphology was 6.03% (95% CI, -1.05 to 13.10). There is a difference in semen volume between moderate and severe infections (MD, 0.52; 95% CI, 0.27?0.76; p<0.0001) and concentration between mild and moderate (MD, 18.74; 95% CI, 1.02?36.46; p=0.04), mild and severe (MD, 43.50; 95% CI, 13.86?73.14; p=0.004), as well as moderate and severe (MD, 22.25; 95% CI, 9.33?35.17; p=0.0007).
Conclusions : SARS-CoV-2 infection may result in decreased sperm concentration in severe cases and the mechanism relates to potential reproductive tract inflammation. The absence of large viral RNA detection in the semen indicates a systemic effect, although this is largely unproven.
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KEYWORD
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COVID-19, Healthy lifestyle, Orchitis, SARS-CoV-2, Sperm
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