May 7, 2020

expert reaction to a study about SARS-CoV-2 in semen

A study, published in JAMA Network Open, reports on the SARS-CoV-2 virus in semen.

Prof Allan Pacey, Professor of Andrology, University of Sheffield, said:

“This is an interesting paper that shows that RNA for the virus responsible for COVID-19 can be detected in the semen of a proportion (15.8%) of men with a confirmed infection. This opens up the possibility that one route of infection may be through sexual contact, although this was not confirmed in the paper. However, whilst the findings appear robust they are at odds with a recent paper by another group from the Tongji Medical College (China) now published in Fertility and Sterility which found no evidence of the virus in semen in a similar number (n=34) of men. This apparent conflict suggests that we need to further work in this area.

“From my own experience of working on microbiological contaminants of semen, I can confirm that there are a number of methodological challenges to overcome in order to truly establish the source of a microbiological infection (virus or bacteria) within the male reproductive tract and moreover that any DNA/RNA represents enough virus/bacteria which are sufficient to cause infection by sexual contact. However, we should not be surprised if the virus which causes COVID-19 is found in the semen of some men, since this is been shown with many other viruses such as Ebola and Zika.”

Prof Richard Sharpe, MRC Centre for Reproductive Health, University of Edinburgh, and Member of the Society of Endocrinology, said:

“This small cohort study has found that a minority of men who have had covid-19 infection diagnosed in a hospital, also exhibit the presence of covid-19 virus in their semen; this included men in the active stage of infection but also a couple of men who were in the clinical stages of recovery from covid-19. It should be noted that the majority of covid-19 infected men, and especially those in the recovery phase, did not test positive for covid-19 virus in their semen.

“As the authors point out, this finding raises the possibility that covid-19 might also be transmissible via semen (and thus via sexual contact), perhaps including during the recovery phase (which would have disease management implications). Whilst this is a small study that leaves many important questions unanswered (eg how long after covid-19 infection does detectable virus persist in semen in those with a semen-positive result), it suggests that obtaining answers to such questions should be an additional priority considering our global need to understand the dynamics of person-to-person transmission of covid-19.”

Prof Sheena Lewis, Emeritus Professor of Reproductive Medicine, Queen’s University Belfast, said:

“This is a very small study undertaken in Shangqiu Municipal Hospital,. In it, only 6 (16%) of  38 men in hospital with Covid-19, tested positive for SARS-CoV-2 in semen. This is encouraging and in keeping with several other small studies recently published.  However, the long-term effects of SARS-CoV-2 on male reproduction are not yet known.”

‘Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019’ by Diangeng Li et al was published in JAMA Network Open at 16:00 UK time on Thursday 7^th May.

All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19

Declared interests

Prof Allan Pacey: “Chairman of the advisory committee of the UK National External Quality Assurance Schemes in Andrology, Editor in Chief of Human Fertility and Trustee of the Progress Educational Trust (all unpaid).  Also, recent work for the World Health Organisation, British Broadcasting Corporation, Purple Orchid Pharma (paid consultancy with all monies going to University of Sheffield).  Co-applicant on a research grant from the Medical Research Council (ref: MR/M010473/1).”

Prof Richard Sharpe: “No conflicts of interest to declare.”

Prof Sheena Lewis: “Sheena is CEO of SpermComet Ltd, a university spin-out company marketing a test for male infertility.”