Abstract
Coronavirus disease 2019 (COVID-19) involves a complex pathogenesis and with the evolving novel variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the long-term impacts of the unceasing COVID-19 pandemic are mostly uncertain. Evidence indicates deleterious impact of this disease upon male reproductive health. It is concerning that COVID-19 may contribute to the already global declining trend of male fertility. The adverse impacts of COVID-19 on male reproduction may primarily be attributed to the induction of systemic inflammatory responses and oxidative stress (OS), which operate as a vicious loop. Bringing the systemic inflammation to a halt is critical for ‘putting out’ the ‘cytokine storm’ induced by excessive reactive oxygen species (ROS) generation. The possibility of OS playing a prime role in COVID-19-mediated male reproductive dysfunctions has led to the advocacy of antioxidant therapy. An array of antioxidant defense medications has shown to be effective in experimental and clinical studies of COVID-19. The present review thus discusses the possibilities as to whether antioxidant drugs would contribute to combating the SARS-CoV-2 infection-induced male reproductive disruptions, thereby aiming at kindling research ideas that are needed for identification and treatment of COVID-19-mediated male reproductive impairments.
Highlights
It has been observed that men are more vulnerable to COVID-19 compared to women [3]
Since secondary immune responses elicited by systemic inflammation and oxidative stress (OS) may cause male reproductive dysfunction in COVID-19 patients [44], anti-inflammatory and antioxidant characteristics of N-Acetyl Cysteine (NAC) may protect the tissues from the oxidative damage
Systemic inflammation, and immune response deficiency are all linked with COVID-19, that may adversely impact male fertility
Summary
Li et al recently reported SARS-CoV-2 presence in semen samples in six individuals, two of whom were recovering from COVID-19 This discovery reopened debates about male genital tract infection, viral shedding in sperm, and prospects of reproductive therapies for COVID19 patients [5]. The testes of deceased COVID-19 patients showed testicular congestion, interstitial oedema, exudation of red blood cells, and T-lymphocyte (CD3+) and macrophage infiltration. Both the testis and epididymides showed elevated inflammatory responses. It is noteworthy that the general mode of actions of any respiratory viral infections (that include inflammatory responses, cytokine production, host cell apoptosis, and subsequently a chain of systemic pathophysiological processes) may be attributed to compromised antioxidant actions and the induction of oxidative stress (OS) [14]. Antioxidant treatments for COVID-19 show promising results; it will be interesting to explore the scope of further research on the possibilities of these antioxidants to ameliorate both COVID-19 and the disease-induced male reproductive dysfunctions
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