Thread by @yaneerbaryam

Update: LongCovid and male infertility

Several articles have shown potential COVID harm to male fertility. A new article is much more explicit.

Massive damage to germ cells (cells that become sperm) indicates potential loss of male fertility.

1/

This autopsy study doesn’t show effect of mild cases. However, studies of mild and asymptomatic cases indicate the virus can reach multiple organs. The ACE2 receptor is highly expressed in testes.

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Title: Pathological and molecular examinations of postmortem testis biopsies reveal SARS-CoV-2 infection in the testis and spermatogenesis damage in COVID-19 patients

nature.com/articles/s4142…

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.”.we evaluated the effects of SARS-CoV-2 infection on spermatogenesis by examining the pathophysiology and molecular features of testes obtained from five male COVID-19 patients at autopsy. The COVID-19 patients were aged 51, 62, 70, 78, and 83 years

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In all five COVID-19 patients, numerous degenerated germ cells (GCs) had sloughed into the lumen of seminiferous tubules (Fig. 1a). In contrast, in the age-matched control tissues, GCs at various stages were well aligned around the whole seminiferous tubules (Fig. 1a).

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Strikingly, in four of the five cases, GC loss was massive, with only a few GCs left attached to the seminiferous tubules. In particular, many seminiferous tubules in the testes of patients 4 and 5 showed almost no intact GCs,

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similar to Sertoli cell-only syndrome.

[note: Sertoli cell only syndrome is a disorder characterized by male sterility]

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Consistent with this morphological observation, the number of DDX4 (a germ cell marker)-positive cells was dramatically reduced in all testicular specimens from the COVID-19 group

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These morphological changes in the testes of COVID-19 patients indicate that SARS-CoV-2 infection may impair male GC development and eventually lead to GC loss.

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Collectively, our findings provide direct evidence that SARS-CoV-2 can infect the testis and GCs, indicating the potential impact of the COVID-19 pandemic on spermatogenesis and male fertility.

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Note: Everything from 4/ to 10/ are quotes from the paper.