Could testicular pain be the only sign of COVID-19? Scientists are studying the effects of the coronavirus on men

Proven content

Scientists are bringing to light the increasingly rare and unusual symptoms of COVID-19. Testicular pain is undoubtedly one of these, especially if it is the only symptom of an infection. And while it’s only been mentioned a few times in research, it has already sparked speculation about the possible effects of the coronavirus on male fertility and potency. Can the gentlemen sleep well?

1. In a 49-year-old patient from Turkey, worsening pain in the left testicle was the first and only symptom of COVID-19
2. A small study in Wuhan shows one-fifth of men with coronavirus infection complain of testicular pain
3. Researchers from Huazhong University of Science and Technology in Wuhan have ruled out that the coronavirus could penetrate testicular cells via ACE2 receptors
4. Prof. Ranjith Ramasamy: “Similar to mumps, about 19 to 20 percent of COVID-30 has been reported. men may have reduced fertility “
5. You can find more about the coronavirus on the TvoiLokony home page

Atypical case of a patient from Turkey

Turkish doctors recorded a very unusual case of coronavirus infection in the summer. A patient came to them who complained of swelling and persistent pain in the left testicle and groin. The man said he felt pain when touched, but no obvious signs of inflammation were found on his skin. The initial discomfort worsened, and after a few hours, additional gastric symptoms appeared. There was no indication of a urinary tract infection or testicular inflammation, usually caused by viruses or bacteria. In addition, the 49-year-old did not have any symptoms typical of COVID-19, such as persistent cough, shortness of breath or fever. Nevertheless, because he reported contact with an infected person, he was tested for the presence of the SARS-CoV-2 virus. The result was positive.

However, before doctors counted testicular pain on COVID-19, they decided to perform an additional series of tests to rule out, for example, sexually transmitted diseases, including chlamydia. Again, the result was negative.

This case was described in the medical journal Urology Case Reports. And Dr. Hakan Özveri, of the Acıbadem Mehmet Ali Aydinlar University in Istanbul, co-author of the article stated that testicular pain was in this case “the first clinical symptom of COVID-19, and patients with isolated symptoms from the genitals, such as pain in the testicles, seminal cord and general discomfort, with no other systemic symptoms, should be tested for COVID-19 ”.

The 49-year-old Turk was treated with an antimalarial drug – hydroxychloroquine and antibiotics, although the doctors did not find a bacterial infection. The pain in the testicles disappeared after 2 days, but the coronavirus remained in his body for another 3 weeks.

1. Does Coronavirus Cause Infertility?

There were a few other patients with similar symptoms

In July, a 43-year-old Massachusetts man hospitalized with testicular pain tested positive for the coronavirus. In November, an Italian who complained of similar ailments died of COVID-19.

Unfortunately, we don’t know how common this problem is. We do not have any studies conducted on a larger scale. Only Chinese doctors at the University of Science and Technology in Wuhan reported cases of 6 (out of 34) men who reported similar symptoms in April. According to them, up to a fifth of infected men may experience testicular pain.

1. Prof. Simon: a fat man, a diabetic drinker – this is our most frequent patient

We don’t know how the coronavirus infects the testicles

Certain viral infections are known to result in inflammation, testicular damage and even infertility. An example is mumps (as well as HIV and cold sores), which can cause pain, inflammation and swollen testicles, sometimes accompanied by reddening of the skin.

However, researchers wondered how the coronavirus penetrated the testicles. Their first choice was the ACE2 receptor. It is a protein found on the surface of the alveoli in the lungs, but also in the cells of the nose and mouth, heart, blood vessels, kidneys, liver and digestive tract. It allows the virus to enter cells, where it then replicates.

Chinese urologists at the Suzhou Affiliated Hospital at Nanjing University found that “the testes strongly express the ACE2 receptor,” which may explain why they are targeted by the virus. In turn, a team of doctors from the Tongji Hospital in Wuhan confirmed that the coronavirus can cause orchitis. As a result, the likelihood of a decrease in sperm count and, consequently, infertility increases.

Meanwhile, a team of researchers from Huazhong University of Science and Technology in Wuhan ruled out the possibility of the coronavirus entering cells via ACE2. The Chinese looked for two genes – ACE2 and TMPRSS2 – that must be present in one cell for the virus to penetrate it and start replication. They found that only four of the 6500 testicular cells had both proteins. Thus, the virus is unlikely to affect the testicles in this way.

So far, no evidence has been found to support the thesis that it travels through the bloodstream.

Can COVID-19 Affect Fertility and Potency?

Given that the testes are responsible for the production of sperm and testosterone, a viral infection could explain the decline in fertility.

It is true that doctors from the San Antonio Uniformed Services Health Education Consortium in Texas warn that COVID-19 may affect male fertility, and as an example cite a 37-year-old whose spermatocytes were damaged by the virus (which divide into sperm). Nevertheless, no study has conclusively proven that the coronavirus affects male reproductive organs, reducing fertility or potency.

Scientists from the University of Miami in Florida examined the testicular tissue of six men who died of COVID-19 under an electron microscope. The mean time from passing the test to death was 11 days, and one male tested positive after death. In three subjects, sperm function was impaired, hypospermatogenesis, i.e. reduced production, and sperm maturation arrest were detected. However, this study does not agree with previous findings showing damage to spermatocytes without infecting the testicles.

Interestingly, a coronavirus has also been identified in a man who underwent a testicular biopsy for infertility and previously recovered from COVID-19. This was so surprising that even six weeks after the infection resolved, when the test was negative, the coronavirus remained in the testicles.

The semen of 60 men was also tested for 30 days after the diagnosis of coronavirus infection. In 19, sperm production decreased, but returned to normal after some time. Scientists suppose that about 50 percent. in men, during an acute course of COVID-19, sperm is damaged in the short term. However, in the long run, 10 to 20 percent may have fertility problems. The estimates here are similar to those for HIV or mumps.

“ These findings are the first step in understanding the potential effects of COVID-19 on male fertility and whether the virus can be sexually transmitted, ” said study co-author, urologist Prof. Ranjith Ramasama.

Prof. Ramasama believes that, as with mumps, about 19 to 20 percent of people who have had COVID-30. men may have reduced fertility. Therefore, she recommends men of all ages who suffer from testicular pain to see a urologist.

“ Testicular pain could be a sign that the coronavirus has penetrated them, ” he says. If men care about fertility, they should check their testosterone levels and sperm parameters, she adds.

See also:

1. Where did SARS-CoV-2 come from? A surprising discovery in laboratory freezers
2. You can be infected with the coronavirus and test negative – how is that possible? [WE EXPLAIN]
3. How to extinguish an epidemic in six weeks? American scientists have an idea for this
4. How did Finland deal with COVID-19? Distance is in their blood

The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website. Do you need a medical consultation or an e-prescription? Go to halodoctor.pl, where you will get online help – quickly, safely and without leaving your home.