Andrological aspects of new coronavirus infection Covid-19


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Abstract

COVID-19 is a new highly contagious infectious disease caused by the SARS-CoV-2. The World Health Organization (WHO) on March 11, 2020, has declared the novel coronavirus (COVID-19) outbreak a global pandemic. More attention is currently paid to the fact that men are more at risk for worse outcomes. In addition, SARS-CoV-2 can infect the testes, potentially affecting testosterone production, as well as having a negative influence on the reproductive potential. Our aim was to review the current concepts of the possible influence of testosterone levels on the pathogenesis of COVID-19 in men and to present the available data on the impact of COVID-19 on the structure and function of the testis. Based on the analysis of 72 articles using the MEDLINE database (PubMed), it can be concluded that testosterone is involved in the co-regulation of the synthesis of angiotensin-converting enzyme-2 and transmembrane serine protease-2, facilitating the penetration of SARS-CoV-2 into target cells and promoting easier infection in men. On the other hand, low testosterone levels increase the risk of cardiopulmonary complications. Hypogonadism appears to be an important unfavorable prognostic factor for the disease. Orchitis is a reported complication of COVID-19. Damage to testicular tissue is possible due to direct invasion by a virus, a secondary autoimmune reaction, hyperthermia and thrombosis of testicular microvessels. Prophylaxis of possible vertical and sexual transmission of infection is recommended. Despite the available data, further studies are required to assess the definite role of androgens in the course of infection and the influence of SARS-CoV-2 on male reproductive potential.

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About the authors

N. D. Akhvlediani

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: nikandro@mail.ru
Ph.D., MD, professor at the Department of Urology Moscow, Russia

I. A Reva

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: rewa-igor@rambler.ru
Ph.D., urologist, acting Head of the Urologic Department of University Clinic Moscow, Russia

A. S Chernushenko

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: artemchemushenko@gmail.com
urologist at the Urologic Department of University Clinic Moscow, Russia

D. Yu Pushkar

A.I. Evdokimov Moscow State University of Medicine and Dentistry

Email: pushkardm@mail.ru
Ph.D., MD, professor, academician of RAS, Head of the Department of Urology Moscow, Russia

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