At present, studies have found that there are different degrees of extrapulmonary organ injury in addition to respiratory symptoms in COVID-19. There is more and more evidence that the virus also affects male reproductive and sexual function, such as testicular pain, impotence, decreased libido, decreased sperm quantity and quality, etc., resulting in a decline in male fertility. Therefore, the impact of COVID-19 on male reproductive and sexual function needs widespread attention.


1.The virus directly infiltrates the testis

COVID-19 directly infects and damages cells by binding to angiotensin converting enzyme 2 (ACE 2) receptor in human tissue. ACE2 is highly expressed in several major cell types such as spermatogenic cells, interstitial cells and Sertoli cells in the testis, which makes the testis a potential target for the virus.

In addition, the virus may cause male sexual dysfunction by destroying gonadal function and changing the endocrine level of the body. Leydig cells produce testosterone (T) under the regulation of luteinizing hormone (LH). The main function of T is to promote the production and maturation of spermatozoa in vivo, and there is a negative feedback mechanism of LH,T, that is, the impairment of T production may stimulate the release of LH and maintain T level temporarily. After infection with COVID-19, the interstitial cells were damaged, T secretion decreased, and negative feedback caused the increase of LH. The study found that the ratio of T:LH decreased significantly, indicating that the ability of patients to produce testosterone decreased and gonadal function decreased.

2.Inflammatory response caused by virus

There is a blood-testis barrier in the normal testis, which can prevent harmful substances and microorganisms from entering the seminiferous epithelium, thus ensuring the normal production of sperm. However, in the acute stage of COVID-19 infection, related inflammation may temporarily affect the integrity of the blood-testis barrier so that it can not prevent virus infiltration and infection, the virus can invade the male reproductive tract through ACE2 on seminiferous tubule cells; in addition, inflammatory cells and their products can activate autoimmune response, lead to autoimmune orchitis, resulting in damage to seminiferous epithelium, all of which may affect sperm production.

3.Other possible mechanisms

After infection with COVID-19, most patients have symptoms of fever, and germ cells must develop at a temperature below 37 °C. Persistent high fever can raise the temperature of the testicles, leading to degeneration and destruction of germ cells. The antiviral drugs used in the treatment also have potential effects on the male reproductive system, such as the combination of ribavirin and interferon can reduce the sperm count, so male patients should strictly monitor their reproductive function while receiving antiviral treatment.

In addition, under the pressure of family and work, men often have bad habits such as long time on the Internet, poor sleep quality, high-salt and high-oil diet, and psychological problems such as anxiety and depression occur from time to time. Many factors may lead to male sexual dysfunction, so COVID-19 patients should be cured regularly, comprehensive detection of sperm count, shape, vitality and other indicators to understand the basic situation of reproductive function, if there is any abnormality. It can be treated in time under the guidance of professional doctors.

Advice for daily life

1.Improve eating and exercise, control diet, and reduce the intake of edible oil and fat.

2.Improve the mood, avoid paying too much attention to the epidemic, and reduce anxiety about the epidemic.

3.Improve sleep and make reasonable schedule. Go to bed on time, reduce the use of electronic equipment before going to bed, ensure 7-8 hours of sleep time, too long and too short sleep time has no effect on improving sleep quality.

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