Adam, D. Will Omicron end the pandemic? 16, 747764 (2020). A phase 2 trial of the effect of antiandrogen therapy on COVID-19 outcome: no evidence of benefit, supported by epidemiology and in vitro data. Presence of SARS-CoV-2 RNA in semen cohort study in the United States COVID-19 positive patients. Hepatol. The detection of SARS-CoV-2 in urine and semen is very rare, but the high prevalence of LUTS in the acute stage of COVID-19 reasonably suggests that the lower urinary tract might still be affected by the virus67,68,70. 32, 151160 (2021). document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); The content of this site is intended for healthcare professionals. Bethesda, MD 20894, Web Policies CE / CME. (sublineages), including BA.5 and BA.2.12.1. & Wang, J. ACE2 expression in kidney and testis may cause kidney and testis infection in COVID-19 patients. }); Hum. Doctors may try existing treatments instead. In the COVIDENZA trial, including men and women >50 years old, the effect of the inhibition of testosterone signalling through enzalutamide on the outcome of hospitalized patients with COVID-19 was evaluated117. If a person tests negative or has new or worsened urinary symptoms after the infection is gone, they should contact a doctor. Vaccines. Male reproductive function Secretion of androgens. It may be that the virus directly infects the urinary tract, causing symptoms, or that the immune response to the virus creates inflammation. 26, 415425 (2021). Heart J. Urinary viral shedding of COVID-19 and its clinical associations: a systematic review and meta-analysis of observational studies. The impact of COVID-19 on fertility plans in Italy, Germany, France, Spain and UK. 2021;93:44204429. This records: This can help a doctor understand the symptoms in more detail. AKI was reported to be the most common complication of COVID-19 in a multicentre cohort study including 80,388 patients with COVID-19 (ref.33). "Initially, it was thought that the disease affects the lungs only. JAMA Netw. Are sex disparities in COVID-19 a predictable outcome of failing mens health provision? Diagnosis of OAB was made using pre-vaccinated OABSS. The incidence of thromboembolism in patients with COVID-19 is similar to that observed in non-COVID-19 pneumonia121, but the pathophysiological background seems to be completely different123,124,126. Baek, M. S., Lee, M.-T., Kim, W.-Y., Choi, J. C. & Jung, S.-Y. In a cancer screening study from the USA including 192,060 patients, thedecrease in PSA testing during the first peak of the pandemic (2 March to 2 June 2020) was 60% compared with three periods of time before and after the peak149. Weln, K. et al. J. Infect. Like all vaccines, COVID-19 vaccines are not 100% effective at preventing infection. Furthermore, androgen-dependent prostate cancer cells highly express TMPRSS2 (a key mediator in viral invasion20) in response to androgens23. Podcast Episodes. If COVID-19 affects a persons urinary tract, they may need to urinate: In some cases, people have also reported passing blood or pus in their urine. Swollen sinuses could be a result of COVID-19. COVID-19-related outcomes in immunocompromised patients: a nationwide study in Korea. 4, e216556e216556 (2021). Two instances of acute necrotizing glomerulonephritis associated with COVID-19 have also been described in children43. As males and older adults are more susceptible to COVID-19 in general, it seems that LUTS may be part of an overall higher burden of illness in these groups. Best, J. C. et al. $('mega-back-mediaresources').on('click', function(e) { Validation of the Arabic linguistic version of the Overactive Bladder Symptoms Score questionnaire. AKI is a severe urological complication of COVID-19 accompanied by high mortality, which is hypothesized to be caused by a cytokine-storm-induced systemic inflammatory response and direct cytopathic effects. $("mega-back-specialties .mega-sub-menu").show(); Moreover, in a prospective cohort study in which patients with COVID-19 (n=89) were compared with patients with non-COVID-19 respiratory tract infection (n=30) and age-matched healthy individuals (n=143), total testosterone levels were decreased in patients with COVID-19, but also in patients with non-COVID-19 respiratory tract infections93, indicating that the observed hormonal imbalances might be a general phenomenon of critical illness, non-specific for SARS-CoV-2 infection95. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. The detection of SARS-CoV-2 in mucous membranes seems to be dependent on the region tested59,60. Google Scholar. Nephrol. and C.G.S. Tolterodine extended release in the treatment of male OAB/storage LUTS: a systematic review. Transl. These results indicate that, although the testes might be heavily affected by a SARS-CoV-2 infection under other circumstances79,81, in these patients, the cause of the imbalances in total testosterone levels lies in the central nervous system, as secondary hypogonadism indicates a problem in the pituitary gland or hypothalamus94. Kidney Int. In another study, the average International Prostate Symptom Score (IPSS), which is used as a validated questionnaire to quantify lower urinary tract symptoms (LUTS)69, was assessed in patients with COVID-19 aged >50 years (n=62) in the acute stage of the disease and surveyed retrospectively for the time before COVID-19 infection70. Last medically reviewed on January 31, 2023. Of these . Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure, Activity 'snacks' could lower blood sugar, complication risk in type 1 diabetes, In Conversation: Investigating the power of music for dementia, Urinary tract infection (UTI) symptoms, causes, and remedies, New COVID-19 strain: What to know about 'Arcturus', Swollen sinuses and COVID-19: What to know, gastrointestinal system, which is responsible for digestion, cardiovascular system, which pumps blood around the body, urinary system, which includes the bladder and urinary tract, less commonly, a cystoscopy or urodynamic testing, the frequency and amount a person urinates, symptoms such as feelings of urgency or urine leakage. Comparison of venous thromboembolism risks between COVID-19 pneumonia and community-acquired pneumonia patients. COVID-19 inflammation results in urine cytokine elevation and causes COVID-19 associated cystitis (CAC). WHO. Public Health 194, 245251 (2021). J. Immunol. The Pfizer-BioNTech vaccine was responsible for 61% of these reports and the Moderna vaccine was responsible for 39%. In this study, no evidence of direct SARS-CoV-2 infection was found in the examined kidney biopsy samples44, whereas, in other studies, the virus could be detected in some kidney samples, although this event seems to be rare and depends on the method of detection. Virol. In another study, impaired sperm quality in patients with COVID-19 was attributed to recurrent fever81, which has been shown to have a detrimental effect on sperm quality84, potentially owing to the thermal dependence of spermatogenesis85,86. Low levels of testosterone were also detected frequently in men with COVID-19, and, in most instances, hypogonadism was secondary. Google Scholar. Post, A. et al. Nat. Single-cell transcriptome analysis of the novel coronavirus (SARS-CoV-2) associated gene ACE2 expression in normal and non-obstructive azoospermia (NOA) human male testes. Storage LUTS should be closely monitored after COVID-19 vaccination, especially in those OAB patients. 18, 223228 (2006). 39, 251.e255251.e257 (2021). 78, e40e41 (2020). Sex-based differences in severity and mortality in COVID-19. BMJ Glob. Scand. However, in a study including 256 patients with COVID-19 pneumonia and 360 patients with non-COVID-19 pneumonia, the rate of venous thromboembolism was not significantly different between the two groups (2% versus 3.6% respectively, P=0.229), indicating that the observed hypercoagulable state in patients with COVID-19 might not be dependent on SARS-CoV-2 (ref.121). PubMed Central Dis. With the virus and clinical research moving at breakneck speed, researchers are . Reprod. made a substantial contribution to discussion of the content. Salciccia, S. et al. Garg, R. K., Paliwal, V. K. & Gupta, A. Encephalopathy in patients with COVID-19: a review. https://doi.org/10.3389/fimmu.2021.771609 (2021). wrote the article. 92, 551571 (2017). Careers. Fajgenbaum, D. C. & June, C. H. Cytokine storm. Department of Urology, University of Texas Southwestern, Dallas TX. Liu, X. et al. Arch. PubMed How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction. Transduct. Is there any association of COVID-19 with testicular pain and epididymo-orchitis? COVID-19-associated coagulopathy is characterized by an isolated elevation of D-dimer (a degradation product from fibrin used as a biomarker of coagulation and fibrinolysis125) and is associated with disease severity and numerous thrombotic complications123. This is a webinar about Bladder Cancer and COVID-19 Treatment and Vaccine Update for Patients and Families. However, bacteria, allergies, fungi, and other viruses can also cause sinusitis. Opin. PLoS ONE 16, e0245556 (2021). Article 108, 244251 (2021). Article The absence of statistically significant differences in IPSS before and during COVID-19 in patients <50 years might be explained by the small sample size of this age group in this study (n=32)70. & Khalid, U. COVID-19 myocarditis and long-term heart failure sequelae. Evaluation of SARS-CoV-2 in human semen and effect on total sperm number: a prospective observational study. However, mounting evidence suggests that infection with the Omicron variant of SARS-CoV-2 (lineage B.1.1.529) causes a milder disease phenotype than previous variants of concern134,135. Expert. De novo urinary symptoms associated with COVID-19, such as increased urinary frequency and nocturia, were also reported in another study including SARS-CoV-2-positive outpatients (n=39)68. Nephrol. Given the common prevalence of many of these reported symptoms in the general population, there does not appear to be a correlation between vaccination and urologic symptoms, but as the vaccination criteria expands, further monitoring of the VAERS is needed.Copyright 2021. In a follow-up analysis (median time: 3 months), the total sperm number in 5 of these 30 men was similar to that reported in the acute phase of COVID-19 (ref.89). Ann. B.E. Ammous, A., Ghaffar, M. A., El-Charabaty, E. & El-Sayegh, S. Renal infarction in COVID-19 patient. Immunol. Internet Explorer). Additionally, people can develop secondary bacterial infections after having a viral infection. Curr. Cheng, Y. et al. The pathogenesis and treatment of the cytokine storm in COVID-19. PubMed Central Severely low testosterone in males with COVID-19: a case-control study. Differently from sepsis-induced disseminated intravascular coagulation, alterations in platelet counts, prothrombin time and partial thromboplastin time are uncommon in the initial presentation of patients with COVID-19-associated coagulopathy126. Scientists theorize this could be a factor in post-COVID-19 LUTS, but more research is necessary to prove this. J. Addressing Covid-19 fear to encourage sick patients to seek emergency care. Song, J. et al. The detection of SARS-CoV-2 in urine and semen is very rare; however, a possible risk of transmission through these body fluids has not yet been ruled out. 4, 13101325 (2014). Snchez-Gonzlez, J. V. et al. Appraising the contemporary evidence. Results from a big retrospective, observational study analysing the incidence of AKI in 3,993 hospitalized patients with COVID-19 showed that AKI occurred in 46% of patients32; 19% of whom required kidney replacement therapy32. People who are up to date with their COVID-19 vaccinations may still get a COVID-19 infection after vaccination . Some people develop them weeks or months after the infection is gone, as part of a condition known as long COVID. A bladder infection is a type of urinary tract infection (UTI). PMC Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. 8600 Rockville Pike It causes waste to build up in your blood and can be deadly. Scientists are not sure what exactly causes these symptoms, so they do not always refer to them as OAB. Regarding urology, no evidence of male or female fertility reduction following COVID-19 vaccination has been reported139. Elhence, A. et al. Virtual press conference on COVID-19 11 March 2020 (WHO, 2020). Sci. Research notes that COVID-19 appears to worsen existing OAB or causes new symptoms, such as urinating. Male hormone levels vary tremendously through acute illness or stress95; therefore, these results should be interpreted with caution. Repercussions of thromboembolism in the genitourinary tract of patients with COVID-19 have also been observed, and include a patient with prostate infarction and several patients with renal infarction associated with COVID-19 (refs127,128,129,130,131). However, SARS-CoV-2 was detected in urine up to 52days after disease onset, indicating that the virus might be detectable in urine in the acute stage of COVID-19 and also after recovery58. J. Clin. Background: In this case report, we describe a potential association between the Pfizer-BioNTech COVID-19 vaccine and development of a vulvar aphthous ulcer in a virginal 14-year-old girl. You can learn more about how we ensure our content is accurate and current by reading our. $('.mega-back-button-deepdives').on('click', function(e) { In most studies, the urinary SARS-CoV-2 viral load was lower than that observed in oropharyngeal or rectal samples58. Both vaccines have been shown to be safe and effective. The immunity someone gains from having an infection, called natural immunity, varies from person to person. COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup. In another study, sperm quality was assessed in 74men aged between 20 and 50 years, who were recovering from COVID-19 (two consecutive negative pharyngeal swab PCR tests were required for inclusion)90. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. J. Antimicrob. As the virus spread, new findings were published on a daily basis and, although the respiratory tract seemed to be the main field of interest, attention soon focused on extra-pulmonary manifestations of the infection5. Urinary frequency as a possibly overlooked symptom in COVID-19 patients: does SARS-CoV-2 cause viral cystitis? Thus, urologists have a crucial role in detecting and managing damage of the genitourinary tract caused by COVID-19. The renin-angiotensin-aldosterone system and coronavirus disease 2019. AKI in patients with COVID-19 also correlates with patients history of chronic kidney disease (CKD)39. To obtain PubMed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233460/, https://www.nature.com/articles/s41585-022-00586-1, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8698875/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597545/, https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html, https://www.sciencedirect.com/science/article/pii/S2666168322020389, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8266265/, https://www.msdmanuals.com/en-gb/professional/infectious-diseases/covid-19/covid-19, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3932953, https://www.urologyhealth.org/urology-a-z/o/overactive-bladder-(oab), New clues to slow aging? The emerging role of ACE2 in physiology and disease. COVID-19-associated coagulopathy can cause endothelial damage and vasculitis, potentially leading to thromboembolism, which also affects urogenital organs. Thus, in the early stages of the pandemic, treatment with androgen deprivation therapy (ADT)32 in men with prostate cancer was hypothesized to be protective against COVID-19 infection106. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. J. Clin. Sci. Cardiologists report that COVID-19-induced myocarditis can lead to fulminant myocardial dysfunction and is associated with poor overall prognosis12. CAS Article The deterioration of storage LUTS was assessed as the increased score of OABSS following vaccination. The angiotensin-converting enzyme 2 (ACE2) receptor, which has a central role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion, is highly expressed in the genitourinary tract, indicating that these organs could be at a high risk of cell damage. Multivariate regression revealed that pre-vaccinated OAB (p = 0.003) was a risk for the deterioration of storage LUTS. De novo lower urinary tract symptoms (LUTS) were observed in 43 patients and deterioration of pre-existing LUTS in 7. A cytokine storm is characterized by an excessive and maladaptive release of pro-inflammatory cytokines during an inflammatory response, which can lead to excessive organ dysfunction47. 197, S189s197 (2017). 46, 11141116 (2020). In neurology, systemic inflammatory responses induced by COVID-19 can result in devastating hypoxic and metabolic changes that can lead to encephalopathy and encephalitis13. ISSN 1759-4820 (online) Kidney J. Carneiro, F. et al. Google Scholar. Fertil. Results from a single-cell RNA-sequencing study showed that the average proportion of angiotensin-converting enzyme 2 (ACE2)-positive type II alveolar cells in the lungs was ~1%, with 1% standard deviation17. Vaccine hesitancy in the era of COVID-19. Testicular tissue can be severely damaged by SARS-CoV-2 infection, leading to a wide range of pathological changes in autopsy studies79,81. Two viral entry pathways (endosomal and cell surface) are available. Due to the severe health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, you should get the vaccine even if you've already had COVID-19. High ACE2 expression levels were found in kidney proximal tubule cells (4% ACE2+ cells) and in bladder urothelial cells (2.4% ACE2+ cells); the percentage of ACE2+ cells in these compartments was even higher than that observed in respiratory epithelial cells (2.0% ACE2+ cells)17. J. Infect. Proc. Bacteriuria in patients with an orthotopic ileal neobladder: urinary tract infection or asymptomatic bacteriuria? Salonia, A. et al. The investigators hypothesized that what they called COVID-19-associated cystitis is caused by an increased inflammatory cytokine release into the urine and/or expression in the bladder72. Thus, this method has been also discussed as a possible tool to evaluate hospital discharge of patients with COVID-19 (ref.59). & Pighin, S. The misunderstanding of vaccine efficacy. Can diet help improve depression symptoms? Reprinted from ref.19, Springer Nature Limited. There is a link between COVID-19 and symptoms that resemble overactive bladder (OAB). Transl. & Azarpira, N. Covid-19 pathogenesis in prostatic cancer and TMPRSS2-ERG regulatory genetic pathway. These results suggest that COVID-19 can affect testis and epididymis in the acute stage of the infection, although these effects might be clinically inapparent in many instances. Cancer symptom experience and help-seeking behaviour during the COVID-19 pandemic in the UK: a cross-sectional population survey. Farouk, S. S., Fiaccadori, E., Cravedi, P. & Campbell, K. N. COVID-19 and the kidney: what we think we know so far and what we dont. Rev. In another study, men recovering from COVID-19 (n=30, median age: 40 years) showed a lower total sperm number than age-matched healthy men89. LUTS do not always appear when a person has COVID-19. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The direct association between increased ACE2 levels and impairment of spermatogenesis supports the hypothesis that organs with high ACE2 levels are at a high risk of cell damage and suggests that the testes might be target organs of SARS-CoV-2. Men might be more vulnerable to infections than women owing to biological causes (including immunological, hormonal and genetic differences) and a worse overall health status102; the higher prevalence of smoking in men than in women might also predispose to worse COVID-19 outcomes102. Eur. J. Urol. Connors, J. M. & Levy, J. H. COVID-19 and its implications for thrombosis and anticoagulation. On 11 March 2020, the WHO declared the COVID-19 outbreak a pandemic4. https://doi.org/10.3390/jcm7120549 (2018). Best. Mei, F. et al. 2019 Jun 12;17(4):265-269. doi: 10.1080/2090598X.2019.1627061. Open. $("mega-back-deepdives .mega-sub-menu").show(); Right: in the presence of TMPRSS2, S2 is cleaved at the cell surface (step 2). Vasc. J. Clin. they have to weigh the risk of COVID-19 infection with the continued risk of going to the hospital and BCG. CAS Med. Reprod. $(".mega-back-deepdives .mega-sub-menu").hide(); Am. JAMA https://doi.org/10.1001/jama.2021.9976 (2021). World J. Mens. Acute necrotizing glomerulonephritis associated with COVID-19 infection: report of two pediatric cases. jQuery(function($) { Difficulty with bladder control or bowel function; . Radiological patterns of incidental epididymitis in mild-to-moderate COVID-19 patients revealed by colour Doppler ultrasound. Eur. Viral orchitides are accepted to lead to a reduction in fertility and endocrine function; therefore, the effects of SARS-CoV-2 on male fertility seem to be a main focus of interest. COVID-19 infection is also associated with endocrine imbalances92,93. Cardiol. However, these effects might also be attributed to fever, and long-term data on sperm quality after recovery from COVID-19 are still very limited. Spike proteins of SARS-CoV-2 are membrane proteins that give the virus its crown-like appearance and bind to angiotensin-converting enzyme 2 (ACE2) receptors on the cellular surface, enabling the entry of the virus19. JAMA Oncol. Y.V., G.M. Thus, ACE2 might have a double role in COVID-19: pro-infection, acting as a cellular receptor for SARS-CoV-2, and protective during SARS-CoV-2 infection, by mitigating inflammation26,29. Med. 9, 678 (2021). Kleymenov, D. A. et al. J. Nephrol. Research suggests there is a link between COVID-19 and symptoms that resemble OAB. Lamamri, M. et al. Liu, W., Han, R., Wu, H. & Han, D. Viral threat to male fertility. doi: 10.3346/jkms.2021.36.e153. Steril. When will the COVID-19 Pandemic End? Cancer Discov. Thank you for visiting nature.com. These contradictory findings might be explained by the anti-inflammatory properties of testosterone113,114, which could also explain why men with COVID-19 and high levels of testosterone (2.9ng/ml total testosterone at hospital admission) test positive for SARS-CoV-2 for a shorter time frame than those with total testosterone levels of <2.9ng/ml (median time to negative PCR test: 26 days versus 18days; P=0.002)115. Kidney Int. COVID-19-related LUTS tend to be worse in people with more severe cases of COVID-19. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Moreover, ischaemia-related priapism was reported as a thromboembolic complication in a 62-year-old patient with COVID-19 (ref.132). At this point, transmembrane protease serine 2 (TMPRSS2) is responsible for the cleavage of spike proteins (defined as priming), which is required for fusion of cellular and viral membranes20 (Fig. 40, 905919 (2021). Nat. B.E., G.M., Y.V. In another study evaluating the potential association between COVID-19 and testicular pain or epididymo-orchitis in 91 patients with COVID-19, 11% of patients reported scrotal pain83. Eur. Gonzalez, D. C. et al. Traish, A., Bolanos, J., Nair, S., Saad, F. & Morgentaler, A. 43, 127131 (2021). Hum. Lucas, J. M. et al. All authors reviewed and edited the manuscript before submission. The experience of European pulmonary pathologists. Zhao, H., Souders, C., Carmel, M. & Anger, J. T. Low rates of urologic side effects following COVID vaccination: an analysis of the FDA vaccine adverse event reporting system. 59, 41804184 (1999). There are no specific treatments for COVID-19-related urinary symptoms. Nat. Nature Reviews Urology thanks A. Kadioglu and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. According to the authors of the recent paper, studies have shown that 10-25% of people with a UTI have contracted an infection. Exam findings were consistent with vulvar aphthous ulcers. In a cohort study including 286 patients with COVID-19 and 281 healthy individuals, significantly lower levels of total testosterone were found in men with COVID-19 at hospital admission than in healthy participants (2.5 nmol/l versus 10.4 nmol/l, P<0.0001)92. Mieusset, R. & Bujan, L. The potential of mild testicular heating as a safe, effective and reversible contraceptive method for men. and J.-N.M. researched data for the article. & Pollak, M. R. APOL1 and kidney disease: from genetics to biology. $(".mega-back-specialties").removeClass("mega-toggle-on"); }); Searching for possible mechanisms explaining the high prevalence of LUTS in patients with COVID-19, the levels of pro-inflammatory cytokines in urine was assessed in a small study including eight participants (four patients with COVID-19 and de novo urinary tract symptoms and four age-matched participants without COVID-19 and with no history of urinary tract diseases)72. This is not very common in people with COVID-19, but research suggests that, when it does happen, UTIs are one of the most common infection types. BJU Int. 2020 May;52(5):815-820. doi: 10.1007/s11255-019-02370-4. Schiavi, M. C., et al. . Curr. Krychtiuk, K. A. et al. Pract. Care Deliv. Save my name, email, and website in this browser for the next time I comment. Google Scholar. A wide range of severe pathological changes can be found in kidney tissue samples from patients with COVID-19 (refs41,42,44), but whether this damage is caused by an exuberant systemic inflammatory response31,41,48,49,50,52 or by a direct cytopathic effect of SARS-CoV-2 (refs31,53,54,55) is still unclear. sharing sensitive information, make sure youre on a federal Sharma, P., Ng, J. H., Bijol, V., Jhaveri, K. D. & Wanchoo, R. Pathology of COVID-19-associated acute kidney injury. Short-term effects of COVID-19 on semen parameters: a multicenter study of 69 cases. }); These observations could suggest either that the viral load of SARS-CoV-2 in the urogenital tract is low or that the viral excretion via the urogenital tract is highly restricted. The Pfizer-BioNTech vaccine was responsible for 61% of these reports and the Moderna vaccine was responsible for 39%. JAMA Cardiol. 2021;106:376381. Moreover, disease severity of COVID-19, measured by hospitalizations and ICU admissions, is higher in men than in women, a phenomenon already observed in previous coronavirus epidemics (SARS-CoV, 2002, and Middle East respiratory syndrome-related coronavirus (MERS), 2012)101. Current and novel biomarkers of thrombotic risk in COVID-19: a Consensus Statement from the International COVID-19 Thrombosis Biomarkers Colloquium. Please enable it to take advantage of the complete set of features! However, the observed reduced sperm quality in patients in the acute stage of COVID-19 could also be attributed to fever84,98, and long-term data on sperm quality after recovery from COVID-19 are still very limited.
