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Covid-19 traced in semen

10 May 2020

By Sarah Hannan Two Chinese doctors recently published a research letter on the Journal of the American Medical Association (JAMA) Network exploring the possibility of SARS-CoV-2 being transmitted sexually, after traces of the virus was found present in the semen of patients. The Sunday Morning contacted STD/AIDS Control Programme Director Dr. Rasanjali Hettiarachchi to clarify whether Sri Lanka too will be looking at the presence of virus in semen of recovering patients. Dr. Hettiarachhchi responded that the current requirement is to obtain saliva swabs for PCR (Polymerase chain reaction) testing. “The findings are still at the research level and once it is clearly defined that it can be sexually transmitted, then we will have to obtain genital secretions for testing,” she noted. The Eighth Medical Centre of Chinese People’s Liberation Army General Hospital in Beijing Department of Respiratory Medicine Dr. Weiguo Zhao MD and Shangqiu Municipal Hospital Henan Province, China Dr. Shixi Zhang MD authored the research letters titled “Clinical Characteristics and Results of Semen Tests Among Men with Coronavirus Disease 2019”, which explored the possibility of SARS-CoV-2 being present in the semen of patients with Covid-19. Dr. Zhao and Dr. Zhang studied that SARS-CoV-2 can be present in the semen of patients with Covid-19, and SARS- CoV-2 may still be detected in the semen of recovering patients. Owing to the imperfect blood- testes/deferens/epididymis barriers, SARS-CoV-2 might be seeded to the male reproductive tract, especially in the presence of systemic local inflammation. Even if the virus cannot replicate in the male reproductive system, it may persist, possibly resulting from the privileged immunity of testes. So far, researchers have found 27 viruses associated with viremia in human semen. But the presence of viruses in semen may be more common than currently understood, and traditional non-sexually transmitted viruses should not be assumed to be totally absent in genital secretions. Studies on viral detection and semen persistence are beneficial to clinical practice and public health, especially concerning viruses that could cause high mortality or morbidity, such as SARS-CoV-2. The study is limited by the small sample size and the short subsequent follow-up. Therefore, further studies are required with respect to the detailed information about virus shedding, survival time, and concentration in semen, Dr. Zhao and Dr. Zhang indicated. If it could be proved that SARS-CoV-2 can be transmitted sexually in future studies, sexual transmission might be a critical part of the prevention of transmission, especially considering the fact that SARS-CoV-2 was detected in the semen of recovering patients. Abstinence or condom use might be considered as preventive means for these patients. In addition, it is worth noting that there is a need for studies monitoring fetal development. Therefore, avoiding contact with the patient’s saliva and blood may not be enough, since the survival of SARS-CoV-2 in a recovering patient’s semen maintains the likelihood to infect others. Dr. Zhao and Dr. Zhang believes that their study might contribute by providing new information to the current discourse regarding Covid-19 prevention and control. This study was partially supported by grant KF2018-06 from the Open Project Programme of the State Key Laboratory of Kidney Diseases in People’s Liberation Army General Hospital.  

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