SARS-CoV-2 in semen: a multicenter prospective study and literature review

Background: Despite numerous efforts to demonstrate the presence of the SARS-CoV-2 in semen of affected males, no clear evidence exists. We conducted a multicenter prospective study on adult patients with a confirmed diagnosis of SARS-CoV-2 including patients with active infection (Active Group) and with a history of COVID-19 disease at least of 6 months (Recovered Group). An RT-PCR test for SARS-CoV-2 and a semen analysis were performed on the semen of the enrolled patients. Genital/sexual symptoms were investigated in both groups. In the active infection group, urinary and sexual functions were assessed in the active phase and after 6 months. Finally, the literature on the detection of SARS-CoV-2 in semen was reviewed non-systematically. Results: Sixty-five patients were enrolled (Active Group = 15, Recovered Group = 50). RT-PCR testing for SARS-CoV-2 found no trace of the virus in any of the semen samples. Genital/sexual symptoms during the active phase were reported in 8 (12.2%) patients. No statistically significant differences in semen quality were found between the two groups. IPSS and IIEF-5 scores did not change significantly during the different phases of infection about (p > 0.05). Conclusions: SARS-CoV-2 was not detected in semen of acute or recovered cases. Sperm parameters were not significantly different in the two groups. Urinary and erectile functions appeared stable across the phases of infection.