P-095 Is SARS-CoV-2 really present in human semen? New evidence on this issue

Abstract

Study questionCan be the SARS-CoV-2 present in human semen samples from patients infected with COVID-19?Summary answerOur research confirms the presence of SARS-CoV-2 in human ejaculate.What is known alreadyIn December 2019 WHO was informed of cases of pneumonia of unknown etiology. This was the beginning of a global pandemic that we are suffering still.COVID-19 disease may damage the male reproductive system. The issue of the presence of SARS-CoV-2 in human semen has been addressed in many studies. Most of them concluded that this virus is not present in human semen. However, until now four groups have reported the presence of SASR-CoV-2.It is quite clear that there is an important controversy about the presence of this virus in semen. Further research is needed to clarify this issue.Study design, size, durationProspective and experimental cohort study to evaluate the presence of SARS-CoV-2 in human semen.Men, COVID-19 disease confirmed, were asked to donate semen sample from July 2020 to March 2021. The patients were recruited with written informed consent.Explicit instructions were given to the correct collection of samples. Participants were interviewed to confirm that collection and transport took place under hygienic conditions. Semen samples were accepted only when instructions were adequately followed.Participants/materials, setting, methodsSemen samples were obtained from 50 men (aged 20-51 years) who were diagnosed with qRT-PCR-COVID19 positive (Ct < 40) in nasopharyngeal swab. Patients were closely followed while in hospital or at home.Each semen sample was divided in three aliquots (1 milliliter each) in order to: 1. Perform a spermiogram, 2. Evaluate SARS-CoV-2 with qRT-PCR-COVID19 and 3. Freeze for later use, if necessary. Patients were asked to provide a new specimen if PCR in semen was positive.Main results and the role of chancePatients included in the study showed different types of pneumonia: mild/moderate (N = 46) and severe (N = 6). Patients with severe symptoms had to be placed in intensive care unit.Average time from admission to hospital to sperm collection was 5,8 days.The study did not find any correlation between fresh semen parameters (volume, pH, count and motility) and severity of illness.SARS-CoV-2 was detected in one of fifty (1/50) fresh semen samples. The patient with SARS-CoV-2 in semen had mild symptoms of pneumonia (fever, headache and muscle pain). The patient was asked about how the semen sample was collected. Standards of hygiene during semen collection were confirmed by patient. Presence of SARS-CoV-2 in patient’s semen sample was verified.Limitations, reasons for cautionIt is possible (though unlikely) that semen sample collection and transportation were incorrect or unhygienic (it was refuted by patient). Besides that, we cannot exclude a false positive in PCR analysis. Although this test has very high specificity with a practical absence of false positives.Wider implications of the findingsAlthough it is evident that the presence of SARS-CoV-2 in human semen is extremely rare, at least four studies confirm this view. In any case the presence of this virus in human semen samples cannot be completely ruled out, on the contrary, further studies are required to confirm this presence.Trial registration number2020-310-1