RESUMO
Coronavirus disease 2019 (COVID-19), which resulted from the pandemic outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a massive inflammatory cytokine storm leading to multi-organ damage including that of the brain and testes. While the lungs, heart, and brain are identified as the main targets of SARS-CoV-2-mediated pathogenesis, reports on its testicular infections have been a subject of debate. The brain and testes are physiologically synchronized by the action of gonadotropins and sex steroid hormones. Though the evidence for the presence of the viral particles in the testicular biopsies and semen samples from COVID-19 patients are highly limited, the occurrence of testicular pathology due to abrupt inflammatory responses and hyperthermia has incresingly been evident. The reduced level of testosterone production in COVID-19 is associated with altered secretion of gonadotropins. Moreover, hypothalamic pathology which results from SARS-CoV-2 infection of the brain is also evident in COVID-19 cases. This article revisits and supports the key reports on testicular abnormalities and pathological signatures in the hypothalamus of COVID-19 patients and emphasizes that testicular pathology resulting from inflammation and oxidative stress might lead to infertility in a significant portion of COVID-19 survivors. Further investigations are required to monitor the reproductive health parameters and HPG axis abnormalities related to secondary pathological complications in COVID-19 patients and survivors.
Assuntos
COVID-19/epidemiologia , Fertilidade , Hipotálamo/patologia , Infertilidade Masculina/epidemiologia , SARS-CoV-2/patogenicidade , Testículo/patologia , Animais , Atrofia , COVID-19/diagnóstico , COVID-19/virologia , Gonadotropinas/metabolismo , Interações Hospedeiro-Patógeno , Humanos , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipotálamo-Hipofisário/patologia , Sistema Hipotálamo-Hipofisário/fisiopatologia , Sistema Hipotálamo-Hipofisário/virologia , Hipotálamo/metabolismo , Hipotálamo/fisiopatologia , Hipotálamo/virologia , Incidência , Infertilidade Masculina/patologia , Infertilidade Masculina/fisiopatologia , Infertilidade Masculina/virologia , Masculino , Testículo/metabolismo , Testículo/fisiopatologia , Testículo/virologia , Testosterona/metabolismoRESUMO
The causes, some pathogenetic mechanisms and possibilities for correcting the decrease in male reproductive potential in Russia are discussed in the lecture. Particular attention is paid to oxidative stress as one of the main causes for subfertility and male infertility, as well as the role of trace elements (zinc, selenium) and antioxidants (vitamins A, E and C) in the pathogenesis of male infertility and opportunities for the correction of fertility issues. Some aspects of COVID-19 influence on the problems of reproductive medicine, andrology and urology are highlighted.