A Systematic Review of the Assessment of the Presence of SARS-CoV-2 in Human Semen.

Theoretically, human testes are highly expressive organs for angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 receptor. This study aimed to investigate whether the causative agent of COVID-19 is found in semen. The databases of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar were searched using a combination of related keywords. All studies with original data, involving detection of SARS-CoV-2 in semen of male patients with COVID-19 or in those who have recovered from it, were included in the study. Six articles, including 136 samples, entered the systematic review. Most of the studies were performed in the recovery phase of COVID-19. In four articles, SARS-CoV-2 was not detected in semen, while in the other two articles semen testing showed the presence of the virus in some samples. Testicular discomfort, testicular cell damage, and spermogram disruption were also reported in some studies. We conclude that the study question cannot be answered with this number of studies. Since most of the samples were mild to moderate forms of COVID-19, it is not yet clear what the presence of the virus in semen will be in severe cases. The long-term effects are also vague. More original articles with better design and in different phases of the disease are needed to draw robust conclusions.