Absence of SARS-CoV-2 in Semen of a COVID-19 Patient Cohort

Background: Since SARS-CoV-2 infection was first identified in December 2019, the novel coronavirus induced pneumonia spread rapidly and triggered a global pandemic. Recent bioinformatics evidence reported that angiotensin converting enzyme 2 (ACE2) was predominantly enriched in spermatogonia, leydig and Sertoli cells, suggesting the potential risk of male reproductive system to be vulnerable to SARS-CoV-2 attack. Methods: From February 26 to April 2, 2020, 23 male COVID-19 patients were recruited in this study. The clinical characteristics, laboratory findings and chest computed tomography (CT) of all patients were recorded in detail. Besides, we investigated semen characteristics and the viral RNA in semen respectively from patients in the acute and recovery phase of SARS-CoV-2 infection by RT-PCR. Findings: All patients tested negative for SARS-CoV-2 RNA in semen specimens. Among them, the virus has been cleared in 11 patients when they tested negative. The rest 12 patient were tested negative for SARS-CoV-2 RNA in semen sample, but with viral RNA positive in sputum specimens or fecal specimens. The median interval from diagnosis to semen samples acquired was 32 days. 32 days after SARS-CoV-2 infection was confirmed, total sperm counts, total motile sperm and sperm morphology of the patients were in normal range. Interpretation: In this cohort of patients with recent infection or recovering from COVID-19, there was no expression of SARS-CoV-2 in semen samples, indicating absence for sexual transmission through semen. Trial Registration: The trial has been registered in Chinese Clinical Trial Registry (ChiCTR2000031779).Funding Statement: Engineering laboratory of urinary organ and functional reconstruction of Shandong province, Jinan Clinical Medical Hygiene and Technology Innovation Plan Program (201907063).Declaration of Interests: The authors disclose no conflicts of interest.Ethics Approval Statement: This study was reviewed and approved by the Medical Ethical Committee of Shandong Provincial Hospital (SWYX: NO.2020-043).