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The data underlying this article will be shared on reasonable request to the corresponding author. So far, studies evaluating semen quality and the occurrence of SARS-CoV-2 in semen of infected or proven recovered men are scarce and included a limited number of participants. Four biological fluid samples, namely saliva, pre-ejaculation urine, semen, and post-ejaculation urine, were tested for the SARS-CoV-2 genome.

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Routine semen analysis and quantification of semen leukocytes and interleukin-8 IL-8 levels were performed. Semen parameters were evaluated according to the World Health Organization manual edition V.

Of the 11 men with semen impairment, 8 were azoospermic and 3 were oligospermic.

A total of 33 patients The low number of enrolled patients may limit the statistical power of study. One-quarter of men who recovered from COVID demonstrated oligo-crypto-azoospermia indicating that an assessment of semen quality should be recommended for men of reproductive age who are affected by COVID Widespread contact tracing followed by hospital isolation or quarantine is recommended to contain the outbreak Swerdlow and Finelli, Human-to-human transmission of SARS-CoV-2 usually occurs within households, including relatives and friends who are in intimate contact with symptomatic or incubating patients Pan et al.

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In some patients, blood samples showed positive RT-PCR test results, suggesting that infection may be occasionally systemic Wang et al. The occurrence of viral genomes in semen of infected men, previously not identified as being sexually transmitted, has been reported for Ebola and Zika Feldmann, A recent study Rastrelli et al.

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However, in view of the essential role alpha blockers for prostate pain by testosterone in spermatogenesis Smith and Walker,alterations of semen quality in patients with COVID can be hypothesized.

In addition, semen parameters may be compromised by the inflammatory condition occurring in men with COVID Few studies have evaluated the presence of the virus in human semen.

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Paoli et al. Li et al. Pan et al. Similarly, Song et al. Only two studies Guo et al.

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In the present study, we investigated the direct RNA presence of SARS-CoV-2 in saliva, urine, and semen; evaluated semen parameters; and investigated semen IL-8 levels as a surrogate marker of the male genital tract inflammatory condition Lotti et al.

Alpha blockers for prostate pain male patients with SARS-CoV-2 infection, confirmed using molecular methods on respiratory specimens, were identified. Men without sexual activity or with ejaculatory disorders, being treated with prostatic surgery or alpha-blockers and those with an inability to express informed consent were excluded from the study.

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Moreover, if one or more specimens collected from the patients enrolled during the study were positive, partners were retested. All enrolled men provided written informed consent.

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Clinical data and specimen collection Clinical data included patient demographics, comorbidities, medications, hospitalization time and features including intensive care needand laboratory tests and treatments including oxygen therapy.

Four biological fluid samples saliva, pre-ejaculation urine, sperm obtained with masturbation, and first fraction post-ejaculation urine were collected in four sterile jars to be tested for SARS-CoV Quantification of leukocytes in semen was performed by counting the number of round cells per milliliter using an improved Neubauer hemocytometer and evaluating the percentage of leukocytes and immature germ cells after May-Grunwald staining of the sample.

Statistics Patients were divided into different groups for comparisons according to hospitalization, intensity of treatment, and semen parameters.

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A logistic regression was carried out including significant factors to better define the risk of sexual transmission and to identify the main determinants of impairment of semen quality. Results Patient characteristics and clinical features From male patients with a positive NP-swab, were between 18 and 65 years of age and were eligible for inclusion, among these, 43 agreed to participate in the study Fig.

All enrolled patients previously affected by COVID had a negative result from at least two consecutive NP swabs before sample collection. Clinical features, including urological and andrological medical history, are summarized in Table I.

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