Researchers have tried to stay on the ball as to all the different health effects that Covid-19 coronavirus infections can have. And some of the latest findings to come out were just published in the journal Emerging Infectious Diseases. A 34 year old man still had the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in his semen 11 weeks after his initial infection. He also had a very low sperm count with none of his sperm really moving around.
This wasn’t just a tweet about someone’s cousin’s friend’s balls. This was a peer-reviewed case report in a respected scientific journal from a team based at the Columbia Mailman School of Public Health and Columbia University Irving Medical Center. The man was part of a larger study conducted by the team.
The case report noted that the man had asthma as a child but didn’t mention any other medical problems prior to his Covid-19 diagnosis in March 2020. That month, the man got infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and then developed severe Covid-19. This landed him in the hospital, where he subsequently was placed on a ventilator and suffered kidney failure. After spending 27 days in the hospital, he finally was well enough to be discharged, although he did remain on dialysis for additional 24 days.
Six weeks after he was first diagnosed with severe Covid-19, the man enrolled in the study run by the team at Columbia. At the time, he had “seemingly” fully recovered from his bout with Covid-19. But his semen ended up showing otherwise. The study consisted 107 participants in total. Study participants completed surveys about their Covid-19 experiences and underwent different types of testing such as sampling of their blood, nasopharyngeal secretions, saliva, stool, and semen.
Only seven of the participants provided semen specimens for a total of 17 semen specimens. It’s not clear from the report how many of the participants were originally asked to provide semen specimens and why only seven ended up doing so. After all, there is typically some prep involved in producing such specimens. People don’t tend to carry around semen specimens just in case someone might ask them for a sample. Regardless, the research team used polymerase chain reaction (PCR) tests to check the semen samples for the presence of SARS-CoV-2 and measured the sperm count, concentration, and motility in the samples.
This is how the team found something semen-ly unexpected. The PCR test detected SARS-CoV-2 in the man’s semen 81 days after he first had severe Covid-19. He also had a very, very low sperm count with a sperm concentration of less than a million per milliliter. Plus, the sperm that were detected in his semen were not really moving around. So in a nutshell, the virus was still affecting his testicles at least 11 weeks after he was first infected with the Covid-19 coronavirus.
Now, finding the virus in semen is not super surprising. As I covered for Forbes in April 2020, back then, there was already groin speculation that the SARS-CoV-2 can affect your testicles. Or “their testicles” if you don’t have them. There have been reports of people suffering testicular discomfort with Covid-19. Moreover, cells in your testes may have a fair number of angiotensin-converting enzyme 2 (ACE2) receptors, which the SARS-CoV-2 can attach to before entering cells. Furthermore, there is evidence that the original SARS virus can cause orchitis just like many other viruses such as HIV, hepatitis B and C, mumps, and Epstein–Barr. By the way, while orchitis may sound like something that you should put in a vase, it is actually a medical term for inflammation of your testicle or testicles. Therefore, if anyone asks whether you want some orchitis for Valentine’s Day, you may want to say no.
What’s a bit surprising about this case report is that the virus was still hanging out in the man’s semen so long after the initial infection. This may be yet another manifestation of long Covid. In this case, “long” doesn’t refer to the size of one’s privates but instead the duration of symptoms. It’s the persistence of Covid-19-related symptoms beyond the three to four week timeframe of an acute Covid-19 coronavirus infection. “Ongoing symptomatic Covid-19” refers to issues that continue through the four to 12 week period after the onset of Covid-19. “Post-Covid-19 syndrome” is when these go beyond 12 weeks, based on the World Health Organization (WHO) definition.
Fortunately, things got better for the 34-year-old man. By Day 101 after his initial diagnosis with severe Covid-19, his sperm concentration had jumped up to 16 million/mL, and by Day 170 it had increased to 72 million/mL.
The man wasn’t the only study participant with low sperm counts. Two other study participants had sperm concentrations of less than 5 million/mL. One other participant had a sperm concentration of less than 15 million/mL with the normal range being 15 million to greater than 200 million sperm per milliliter of semen. Five of the study participants provided follow-up semen samples. For all, the sperm counts increased with time. Three ended up reaching the normal range in subsequent samples.
Before you go nuts about the results, keep in mind that this is a very small sample. A study with so few participants really can’t tell you how frequently the SARS-CoV-2 may hit the sack, so to speak. More studies are needed that include hundreds or perhaps even thousands of people offering their semen samples.
Of course, one concern with finding the SARS-CoV-2 in the sack is what may happen with a roll in the sack. Finding the virus on or in people’s genitals doesn’t necessarily mean that Covid-19 may be a sexually transmitted disease. Viruses are like people storming the Capitol. There has to be enough of them to cause real problems. In the case of a virus, there has to be an infectious dose to cause an infection.
Ultimately, this case report can only show what may be possible and plant the seeds for future studies. So it will be important to keep an eye on the balls, many more balls. For now, there is one conclusion that you can come to: Covid-19 is really complex problem, a lot more complex than many people realize.