The first step in understanding the potential routes of transmission — and their ramifications — is knowing which tissues the virus is capable of penetrating. “Previous SARS strains have shown an ability to cross into the male reproductive tract, where it can be sexually transmitted,” said Ranjith Ramasamy, M.D., associate professor of urology at the Miller School of Medicine and director of male reproductive medicine and surgery at the University of Miami Health System and the Miller School.
Men who tested positive for COVID-19 are now being enrolled in a unique study led by the University of Miami to determine the interaction of the virus with semen. There are 35 men currently enrolled and the study is looking to enroll a total of 200 COVID-19 positive men.
“We hypothesize that SARS-CoV-2 may be present in the semen and be a source of transmission,” Dr. Ramasamy said. “Understanding the potential for COVID sexual transmission is critical because of the tremendous potential ramifications.”
According to Dr. Ramasamy, studies show that up to 20 percent of men with asymptomatic COVID infection may have an infection in one or both testes, a condition known as orchitis. “We want to identify how long the presence lasts in semen and investigate whether COVID infection leads to orchitis and male infertility.”
The gateway into the body for this virus is the ACE2 receptor, present in multiple organs, including the lungs, heart, intestines, kidneys, and testis. “The COVID receptor is present in a lot of testes. The testis is responsible for sperm and testosterone production. So we not only want to check testosterone levels, but also research if young men have changes in their sperm counts.”
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