Male Reproduction and Health after Recovery from COVID-19 Infection

Abstract

Objective. To study the reproductive hormones, semen quality, psychology, and sexual function of childbearing age men after recovery from Corona Virus Disease-2019 (COVID-19) infection. Materials and Methods. We recruited 387 men of childbearing age who recovered from COVID-19 infection and underwent prepregnancy health checks at the Reproductive Center of Shandong Maternal and Child Health Hospital from January to March 2023 as study subjects. Routine semen analysis and reproductive hormones were performed. The clinical symptoms, anxiety, depression, erectile function, and premature ejaculation questionnaire were investigated during the COVID-19 infection period. A control group of 226 men of childbearing age who were not infected with COVID-19 between August 2022 and October 2022 were selected based on questionnaire responses, reproductive hormones, and semen parameters. Results. The main clinical symptoms during COVID-19 infection of the 387 research subjects were fever (342/387, 88.37%), muscle pain (155/387, 40.05%), anosmia (124/387, 32.04%), cough (106/387, 27.39%), throat pain (53/387, 13.70%), nausea and vomiting (16/387, 4.13%), and testicular discomfort (5/387, 1.29%). The rates of anxiety and depression were 11.37% (44/387) and 32.82% (127/387), respectively; erectile dysfunction (ED) and premature ejaculation (PE) of the research subjects were accounted for 32.30% (125/387) and 6.98% (27/387). The IEF-5 score (P<0.001) decreased significantly compared to the control group, while the PHQ-9 score (P<0.001), the rate of increased ED (P<0.001), and the rate of depression increased (P<0.001). There were statistically significant differences in liquefaction time (P<0.05), the progressive sperm motility (P<0.05), total sperm motility (P<0.05), the rates of progressive sperm motility <32% (P<0.05), and total sperm motility <40% (P<0.05) between the 1 month, the 2 months after recovery from COVID-19 and controls. Circular cell counts (P<0.05) at 2 and 3 months were lower than in the controls. No changes in reproductive hormones before and after recovery from infection. Conclusion. COVID-19 infection exacerbates depression and ED. It has a sustained effect on sperm motility and liquefaction time in men. The effects of COVID-19 infection on semen persist for approximately 2 months, with recovery occurring in the third month. Reproductive hormone levels do not appear to be continuously affected after recovery from COVID-19.