The pandemic of SARS-CoV-2 has raised many questions regarding the impact of the virus on the human body. The possibility of sexual transmission of the virus is of major interest, especially to those offering assisted reproductive technology (ART) services and donor sperm banks. Recent findings reveal that angiotensin converting enzyme 2 (ACE 2), which is found in testicular tissue, plays a role in the pathogenesis of SARS-CoV-2. A novel study conducted by Cryos International - USA based in Orlando, Florida, aimed to investigate if coronavirus (SARS-CoV-2) could be detected in human semen and thereby sexually transmitted.
Prior studies have conducted similar investigations, but the results have been inconclusive. The studies have been limited with only a few included patients in various stages of infection, with most in the recovery phase of the illness. A study by Holtmann et al. (2020) looked at 18 patients who had recovered from SARSCoV-2 infection and found no evidence of viral RNA in their semen.
This novel study was conducted as a cohort study and included eighteen (18) men with a median age of 32 (range 24-57 years) who tested positive for COVID-19 by real-time PCR analysis and provided a semen sample. The study group demonstrated symptoms of COVID-19 ranging from asymptomatic to moderate and none of the men required hospitalization. The time from virus detection to semen collection ranged from 1 to 28 days (median 6 days).
Viral RNA was extracted from the collected spermatozoa and reactions for real-time RT-PCR were assembled in triplicates. A dilution series of SARSCoV-2-gene transcript RNA served as a positive control to determine the presence of SARS-CoV-2 RNA in the semen.
Results from real-time PCR assays for all samples were negative for SARS-CoV-2. These results are supported by Kayaaslan et al. (2020) who found no evidence of viral RNA 16 in the semen of patients with acute SARS-CoV-2 infections.
One weakness of our study is that no severely infected men participated. Given our small sample size, further studies are needed to determine conclusively if SARS-CoV-2 can be present in semen, particularly in men with severe symptoms from COVID-19.
The primary route of SARS-CoV-2 infectivity is widely accepted to be respiratory, however, virus RNA has been detected in blood, urine, and stool specimens. Extensive research continues to elucidate the locations of the SARS-CoV-2 in the human body and its modes of transmission.
Based on these results and consistency with prior findings, that no SARS-CoV-2 was detected in sperm, we suggest SARS-CoV-2 is not present in semen during the acute or convalescent phase of COVID-19 and cannot be sexually transmitted. However, the study underlines, that other modes of transmission are present during intercourse. Therefore, it is not safe to say that COVID-19 cannot be transmitted during intercourse in general.