An Assessment of Men Semen Alterations in SARS-CoV-2: Is Fever the Principal Concern?

The SARS-CoV-2 virus (COVID-19) was identified as a pandemic in March 2020 by the World Health Organization. The virus spreads primarily through saliva droplets or nasal discharges, in addition to coughing or sneezing from an infected person. The most common symptom at the onset of illness is fever, which may appear within 2–14 days after exposure. The high fever (above 38 °C) can persist from one to 4 days. The febrile illness usually has a variable negative impact on sperm characteristics such as sperm output, motility, morphology, and DNA fragmentation. These defects proliferated due to an increase in testicular temperature, and disturbance in the thermoregulatory systems that are responsible for the testicular heat loss. Coronavirus studies suggest that fever from SARS-CoV-2 virus infection induces a reversible negative effect on the sperm parameters until one cycle (74 days) of spermatogenesis. We believe that SARS-CoV-2 can have long-term adverse effects on testicles via immune or inflammatory reactions after the patient has fully recovered. This evidence could be added to the list of the long-term post-COVID-19 syndromes. Long-term follow-up and evaluation of the sperm parameters are necessary for all recovered male patients, especially the young ones.