目的:由于ACE2受体表达,SARS-CoV-2感染对男性生殖道的影响越来越受到关注,然而,其影响尚不清楚。我们进行了这篇综述,以评估SARS-CoV-2感染是否会影响男性生殖系统。
方法:我们在Embase中进行了搜索,Scopus,和MEDLINE数据库,遵守系统审查和荟萃分析(PRISMA)指南的首选报告项目。符合条件的研究包括报道精液中病毒RNA存在的文章,精子参数,SARS-CoV-2患者发生睾丸炎或睾丸附睾炎。使用纽卡斯尔-渥太华量表(NOS)确定观察性研究的质量。病例报告使用JoannaBriggs研究所(JBI)的检查表进行评估。
结果:共纳入32篇相关文章。从3项研究中,在7%的感染患者精液中发现了病毒RNA(95%CI,-0.01至0.15)。也只有7%的患者有睾丸炎或睾丸附睾炎临床表现(95%CI,0.05-0.10)。精液体积和浓度分别为2.34mL(95%CI,1.87-2.81)和51.73百万/mL(95%CI,31.60-71.85)。进展和总运动百分比分别为36.11%(95%CI,28.87-43.35)和43.07%(95%CI,28.57-57.57),分别。形态为6.03%(95%CI,-1.05至13.10)。中度和重度感染之间的精液体积存在差异(MD,0.52;95%CI,0.27-0.76;p<0.0001)和轻度和中度之间的浓度(MD,18.74;95%CI,1.02-36.46;p=0.04),轻度和重度(MD,43.50;95%CI,13.86-73.14;p=0.004),以及中度和重度(MD,22.25;95%CI,9.33-35.17;p=0.0007)。
结论:SARS-CoV-2感染可能导致严重病例的精子浓度降低,其机制与潜在的生殖道炎症有关。精液中没有检测到大的病毒RNA,这表明了系统效应,虽然这在很大程度上是未经证实的。
OBJECTIVE: There is a growing concern regarding the impact of SARS-CoV-2 infection on the male reproductive tract due to ACE2 receptor expression, however, its impact remains unclear. We performed this
review to evaluate whether SARS-CoV-2 infection affects the male reproductive system.
METHODS: We conducted a search in the Embase, Scopus, and MEDLINE databases, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Eligible studies comprised articles reporting viral RNA presence in semen, sperm parameters, and
orchitis or orchiepididymitis occurrence in SARS-CoV-2 patients. Observational studies\' quality was determined using the Newcastle-Ottawa Scale (NOS). Case reports were assessed using the Joanna Briggs Institute (JBI)\'s checklist.
RESULTS: A total of 32 relevant articles were included. Viral RNA was found in 7% of infected patients\' semen (95% CI, -0.01 to 0.15) from 3 studies. There were also only 7% of patients with
orchitis or orchiepididymitis clinical manifestations (95% CI, 0.05-0.10). The semen volume and concentration were 2.34 mL (95% CI, 1.87-2.81) and 51.73 million/mL (95% CI, 31.60-71.85). The progressive and total motility percentages were 36.11% (95% CI, 28.87-43.35) and 43.07% (95% CI, 28.57-57.57), respectively. The morphology was 6.03% (95% CI, -1.05 to 13.10). There is a difference in semen volume between moderate and severe infections (MD, 0.52; 95% CI, 0.27-0.76; p<0.0001) and concentration between mild and moderate (MD, 18.74; 95% CI, 1.02-36.46; p=0.04), mild and severe (MD, 43.50; 95% CI, 13.86-73.14; p=0.004), as well as moderate and severe (MD, 22.25; 95% CI, 9.33-35.17; p=0.0007).
CONCLUSIONS: SARS-CoV-2 infection may result in decreased sperm concentration in severe cases and the mechanism relates to potential reproductive tract inflammation. The absence of large viral RNA detection in the semen indicates a systemic effect, although this is largely unproven.