Assessment of SARS-CoV-2 in human semen - a cohort study

Nora, Holtmann; Philippos, Edimiris; Marcel, Andree; Cornelius, Doehmen; Dunja, Baston-Buest; Ortwin, Adams; Jan-Steffen, Kruessel; Petra, Bielfeld Alexandra

Abstract Objective To investigate the presence of viral RNA in human semen of severe-acute-respiratory syndrome coronavirus 2 (SARS-CoV-2) recovered and positive patients and to evaluate its presence and relevance on semen parameters. Design Pilot cohort study Setting University hospital Patients 34 adult males were distributed into a) patients in convalescence (patients with confirmed SARS-CoV-2 infection in pharyngeal swab by RT-PCR and/or antibodies), b) negative control group (no antibodies) and c) patients with an acute infection (detection of SARS-CoV-2 in pharyngeal swab). Intervention Semen and a blood sample were collected from each individual. Main outcome measures Analysis of semen quality according to the WHO standards. Detection of SARS-CoV-2 by RT-PCR in the native semen sample and after density gradient preparation. Confirmation of Immunoglobulin (Ig)-A und Ig-G antibodies in the blood. Results 18 semen samples from recovered males were obtained 8 to 54 days after absence of symptoms, 14 samples from controls and 2 samples from patients with an active COVID-19 infection. No RNA was detected by RT-PCR in the semen including semen samples from two patients with an acute COVID-19 infection. Subjects with a moderate infection showed an impairment of sperm quality. Conclusion A mild COVID-19 infection is not likely to affect testis and epididymis function, whereas semen parameters did seem impaired after a moderate infection . SARS-CoV-2 RNA could not be detected in semen of recovered and acute COVID-19 positive males. This suggests no viral transmission during sexual contact and assisted reproductive techniques (ART), however, further data need to be obtained.