Wear a Mask, Save the Family Jewels

So, I did a bit of a lit review on one of the effects of covid-19 that isn't getting a ton of coverage, and might be meaningful to some folks. Having put the work in, I'm posting it *everywhere*.

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A friend posted a story from a paper published back in April about covid-19 causing male infertility. As a policy, I don't randomly repost things without checking them out, and also wanted to make sure this wasn't the one paper telling a story different from all the others. So, I went up to pubmed to do a bit of lit review.

This is the original paper: "Furthermore, male reproductive systems are vulnerable to infection; dramatic changes in sex hormones in patients with COVID-19 have been observed, suggesting gonadal function impairment." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186932/

However, on pubmed I was pretty shocked by just how many papers there are on this subject. I mean, sure, we're all hearing about the deaths, and I don't particularly follow fertility literature... The following are the most relevant papers from just the first two pages of results. Pull quotes selected for relevance. (When possible, I pulled up the pubmed full text of the articles, but as you'll see if you follow the links, they're across a broad variety of journals.)

"The highest expression recorded in patients aged 30, which is higher than those in their twenties, whereas 60-year-old patients show the lowest level of expression [4]. This might indicate that young male patients are at higher risk of testicular damage by COVID-19 than older patients." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171435/

"The main host receptor of the SARS-CoV-2 is angiotensin converting enzyme 2 (ACE2), a major component of the renin-angiotensin-aldosterone system (RAAS). The ACE2 is also involved in testicular male regulation of steroidogenesis and spermatogenesis." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276979/

"High level of expression in testis, cardiovascular and gastrointestinal system indicated that SARS-CoV-2 might not only attack the lungs, but also affect other organs, particularly the testes, thus it may severely damage male sexual development for younger male and lead to infertility in an adult male, if he contracted COVID-19." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7224351/

"Severe Acute Respiratory Syndrome Coronavirus 1 (SARS–CoV-1) may cause severe orchitis leading to germ cell destruction in males. ...but it is unclear whether SARS–Coronavirus 2 (CoV-2) adversely affects female gametogenesis." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161522/

"Of interest is existing evidence that orchitis can develop due coronavirus infection. It is therefore not unreasonable to believe that SARS-CoV-2 could be transmitted by semen." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162782/

"Testes from COVID-19 patients exhibited significant seminiferous tubular injury, reduced Leydig cells, and mild lymphocytic inflammation." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261470/

"A direct invasion of SARS-CoV-2 virus is caused by ACE2 receptors likely causing direct testicular damage, or by affecting testicular functions by secondary immunological and inflammatory responses." https://link.springer.com/article/10.1007/s43032-020-00261-z