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Urological complications of COVID-19: a systematic review

Luca Schiliró Tristão1, Rafael Bresler1, Victoria Andrade Modesto1

  • 1Departamento de Medicina Baseada em Evidências, Faculdade de Ciências Médicas de Santos (FCMS-UNILUS), Santos, SP, Brasil.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|December 13, 2022
PubMed
Abstract

Insights

COVID-19 can affect the urinary tract and male reproductive system, potentially causing symptoms like lower urinary tract issues and impacting male fertility. Testosterone levels may indicate disease severity.

Area of Science:

  • Urology
  • Infectious Diseases
  • Reproductive Medicine

Background:

  • COVID-19, caused by SARS-CoV-2, utilizes ACE2 receptors found in the lungs, bladder, prostate, and testicles, posing risks to these organs.
  • Non-respiratory symptoms of COVID-19 may be linked to the virus's impact on these ACE2-rich areas.

Approach:

  • A systematic review guided by the PRIMSA statement was conducted to identify urological complications associated with COVID-19.
  • Searches encompassed major databases (Medline, PubMed, CENTRAL, Embase, MedRxiv, LILACS) up to April 2022.
  • Bias analysis was performed using the Newcastle-Ottawa Scale.

Key Points:

  • Lower urinary tract symptoms and acute scrotum can be manifestations of COVID-19 in men.
  • COVID-19 may temporarily affect male fertility, indicated by changes in sperm parameters.
  • Reduced testosterone levels were observed in some patients, potentially serving as a severity biomarker.

Conclusions:

  • COVID-19 can have repercussions on the male urinary and reproductive systems.
  • Further research is needed to determine the long-term effects of COVID-19 on male fertility.
  • Transmission of SARS-CoV-2 via semen is considered highly unlikely.
Keywords:
COVID-19InfertilityTestosterone

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