By Eleanor Frederick, MSc. MPH
COVID-19, the disease caused by the novel coronavirus SARS-Cov-2, was
declared a global pandemic in February 2020. COVID-19 is a respiratory tract
infection that affect your upper respiratory tract (sinuses, nose and throat) or the
lower respiratory tract (trachea and lungs).
SARS-Cov-2 is transmitted from person-to-person by respiratory droplets from the
nose and mouth as well as contact; it has resulted in the deaths of more than four
million people across the globe. Infections range from asymptomatic to mild and
severe.
The WHO stated that COVID-19 could definitely be spread by kissing but it was
too soon to tell if can be sexually transmitted.
Previously Mead PS. et al., New England Journal of Medicine (NEJM), (2018) had
reported evidence that other infectious viruses including Zika and Ebola may be
sexually transmitted. This information prompted questions as to whether SARS-
Cov-2 could be sexually transmitted.
According to a report by Guan W., et al. in the NEJM, February 28, 2020, the only
other bodily samples from which the virus has also been detected besides the
respiratory samples were stool, saliva and the gastrointestinal (GI) tract.
Subsequently other studies have also reported the virus in blood as well as the tears
of COVID-19 patients with inflammation in their eyes.
However, on Thursday a study was reported in the JAMA Network Open, 2020;
and it states that “SARS-Cov-2 was found in the semen of patients with COVID-19
and also in the semen of patients who were recovering from the disease”.
The study tested the semen from 38 patients at Shangqiu Municipal Hospital in
Henan Province in central China. The patients ranged in age from 15 to 59, and
had previously tested positive for the coronavirus. Of the 38 participants, 23 or
(60.5%) had recovered clinically and 15 participants or (39.5%) were still in the
acute stage of infection.
Beijing et al., of the Eighth Medical Center of Chinese People’s Liberation Army
General Hospital in the Shangqiu Municipal Hospital in Henan, noted that “there
was no significant difference between negative and positive test results for patients
by age, urogenital disease history, days since onset, days since hospitalization, or
days since clinical recovery.”
Results from the study confirmed the detection of genetic material from SAR-Cov-
2 in the semen from six patients, which is approximately 16% of the total. They
noted 4 of 15 participants (26%) who were in the acute stage of the disease and
two of 23 participants or (8.7%) were recovering. They also noted that it had been
16 days since one of the men had first shown symptoms. They stated that the study
group was small and there was no long-term follow-up so it is not known how long
the virus may remain in semen or if men can spread it to their partners during sex.
The results are said to contrast with a study of 34 Chinese men with COVID-19
that was published last month in the Journal of Fertility and Sterility (JFS). In that
study researchers in the U.S. and China found no evidence of SARS-Cov-2 in
semen that was tested between eight days and almost three months after diagnosis.
Dr. John Hotaling a co-author of this study in JFS said the new study involved men
with severe COVID-19 infection; and most of them were in the active phase of the
disease. He stated further that “it’s an important public health concern but that
more research is needed to provide a definitive answer.”
Dr. Stanley Perlman, professor of Microbiology, Immunology and Pediatrics at
University of Iowa states that “if semen tests positive for coronavirus that does not
mean that infectious virus is present.
Dr. Peter Schlegel, immediate past president of the American Society for
Reproductive Medicine, said: “The new study shouldn’t be cause for alarm. To be
safe, though, it may be wise to avoid sexual contact with men until they are 14
days without symptoms.”
The authors of the study state that “studies in viral detection and semen
persistence are beneficial to clinical practice and public health, especially
concerning viruses that could cause high mortality and morbidity such as SARS-
Cov-2”.
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