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

Plain-language summary

This is a narrative review, which means the authors gathered and discussed existing work rather than running a study of their own. It asks whether the damage COVID-19 does to semen is mostly the fever rather than the virus. Fever is the commonest symptom at the onset of illness, and a high fever above 38 degrees Celsius (100.4 degrees Fahrenheit) can run for one to four days. The authors set out the case that a fever raises the temperature inside the testicles and disturbs the mechanisms that normally keep them cooler than the rest of the body, and that this is what worsens sperm output, movement, shape and DNA integrity. They report that the coronavirus studies they reviewed point to a reversible effect lasting about one full cycle of sperm production, roughly 74 days. They also state their own belief, rather than a finding, that the virus may act on the testicles for longer through immune or inflammatory routes even after recovery.

Key findings

• Fever is the commonest symptom at the onset of COVID-19, and a high fever above 38 degrees Celsius (100.4 degrees Fahrenheit) can last from one to four days.
• A febrile illness is linked to worse sperm output, movement, shape and DNA integrity.
• The authors attribute that to a rise in testicular temperature and to disturbance of the mechanisms that keep the testicles cooler than the body.
• The coronavirus studies reviewed point to a reversible effect lasting about one cycle of sperm production, roughly 74 days.
• The claim that the virus has longer-term effects on the testicles through immune or inflammatory routes is stated by the authors as a belief, not as a result.
• The authors call for long-term follow-up and sperm testing in all recovered male patients, and particularly in young men. That is their recommendation, and the review tested nothing.
• This is a narrative review. It ran no experiment and tested no intervention.