男性新型冠状病毒肺炎患者生殖系统损伤机制研究进展

新型冠状病毒肺炎(COVID-19)在发病率和严重程度上存在显著的性别差异,同年龄段中男性患者多于女性患者。新型冠状病毒(SARS-CoV-2)利用血管紧张素转换酶(ACE)2受体进入人体细胞。由于ACE2在人类多个器官系统上有不同程度的表达,SARS-CoV-2除感染呼吸系统外,同样可以感染消化系统、神经系统、免疫系统等。睾丸为富含ACE2的器官之一,部分男性COVID-19患者精液中检出SARS-CoV-2,SARS-CoV-2可能损伤生殖系统。但SARS-CoV-2参与男性生殖系统损害的机制尚未完全阐明,目前研究主要集中在SARS-CoV-2对男性生殖的短期影响,并越来越重视其长期影响。本文总结了SARS-CoV-2介导男性COVID-19患者的生殖细胞损伤、性腺功能减退、睾丸炎症的可能机制,并指出目前研究存在的问题,为男性COVID-19患者生殖系统损伤的机制研究扩宽思路。

Research Progress on Reproductive System Damage in Male Coronavirus Disease 2019 Patients

The incidence and severity of coronavirus disease 2019(COVID-19) have significant gender differences.Males are more likely to contract severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) than the age-matched females.The virus uses angiotensin-converting enzyme 2(ACE2) receptors to enter human cells.In addition to infecting the respiratory system,ACE2 can also attack the digestive system,nervous system,immune system and so on,due to the various levels of expression in multiple human organs.The testes are one of the ACE2-rich organs.SARS-CoV-2 has been detected in the semen of some COVID-19 patients,which suggests that SARS-CoV-2 may damage the male reproductive system.However,the damage mechanism remains to be studied.The available studies focus on the short-term effect of SARS-CoV-2 on male reproduction and increasing attention has been paid to the long-term effect.This paper briefly describes the possible mechanisms of reproductive cell damage,hypogonadism,and testicular inflammation mediated by SARS-CoV-2 in male COVID-19 patients and points out the existing problems in the current studies,which will broaden the thinking for deciphering the mechanism of reproductive system damage in male COVID-19 patients.