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Detection of 2019 novel coronavirus in semen and testicular biopsy specimen of COVID-19 patients

Our take —

This case series, which was available as a preprint and thus not yet peer reviewed, looked at the presence of SARS-CoV-2 in semen and testicular tissue samples among patients in recovery from COVID-19, and one deceased patient. While this study was small, it was found that there were no positive samples found in semen or testicular biopsy. Studies assessing viral replication among asymptomatic cases and during disease are necessary to shed additional light on sexual transmission.

Study design

Case Series

Study population and setting

A total of 12 male COVID-19 patients who were in recovery were recruited from January 31 to March 14th, 2020. Recovery was defined as period after viral clearance (two continuous negative nucleic acid tests), or with lessened symptoms; patients with severe disease were excluded. An additional deceased patient was included. Clinical characteristics, laboratory findings, chest CT scans, and outcome data were reviewed for all 13 men. Semen samples were collected from the 12 surviving patients and testicular tissue sample was obtained from the deceased patient, and all samples were tested for SARS-CoV-2 by using qRT-PCR kits.

Summary of Main Findings

The 12 patients in recovery ranged in age from 22-38 years. None of these patients developed severe COVID-19 pneumonia, and all 12 patients tested negative for 2019-nCoV RNA in semen samples. The 1 patient who died was 67 years old and the tissue sample collected via testicular biopsy on this patient also tested negative for viral RNA.

Study Strengths

No distinct strengths were noted.

Limitations

The sample was very small (only 13 patients), and outside of age and clinical characteristics related to 2019-nCoV, we do not know much about how representative these patients would be of a larger group of men. It is also unclear how the timing of sample collection (post-recovery) may have impacted detection of viral RNA.

Value added

This study provides limited early evidence against the presence of SARS-CoV-2 in semen among patients in recovery who never had severe illness.