Background

There is evidence that, after SARS-CoV-2 infection, male reproductive function and semen quality may be damaged

Objectives

To evaluate a panel of inflammatory mediators in semen in patients recovered from COVID-19.

Material and methods

Sexually active men with previous SARS-CoV-2 infection and proven recovery from COVID-19 were enrolled in a prospective cohort study. Clinical, uro-andrological data and semen specimens were prospectively collected. For previously hospitalized COVID-19 patients, data on serum inflammatory markers were retrospectively collected.

Results

A total of 43 men were enrolled in the study. Of these, 32 men were normozoospermic, 3 oligozoospermic and 8 crypto-azoospermic. Serum inflammatory markers (procalcitonin and C-reactive protein) were analyzed in previously hospitalized patients both at admission and at peak of infection. Levels at admission were statistically significant higher in patients resulting crypto-azoospermic respect to those resulting normospermic (p = 0.05; p = 0.03 and p = 0.02, respectively) after healing. Seminal cytokine levels were similar among all groups. IL-1β and TNF- α levels were significantly negatively related to sperm total number and concentration, whereas IL-4 was correlated with sperm motility.

Discussion and conclusion

Negative correlations between IL-1β and TNF-α and sperm number and the, overall, high levels of semen cytokines indicate a potential detrimental role of SARS-CoV2 driven inflammation on spermatogenesis. Overall, our results indicate that male patients recovering from COVID-19 deserves accurate follow up for their fertility status.

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