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?:abstract
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Objective: The coronavirus disease 2019 (COVID-19) caused by the SARS-CoV-2 quickly grew into a global pandemic The virus has been known to impact the respiratory system;however, the extent of impact on testicular tissue remains unknown It has been found that COVID-19 binds to angiotensin converting enzyme (ACE) 2 receptors, and since ACE2 expression is high in the testes we believe COVID-19 may be prevalent in testes tissue Design: In the present study, we analyzed the pathological changes within the testes of three patients who died of COVID-19 pneumonia and sepsis Materials and Methods: In the present study, autopsy collection was done according to the University of Miami protocol Testes tissue we collected from COVID-19 positive men (n=3) as well as COVID-19 negative men (n=3) to be used as controls Tissue was formalin fixed and paraffin embedded Samples were sectioned to 5-micron sections and stained with hematoxylin and eosin (H&E) as well as subjected to various fluorescently labeled antibodies to specifically differentiate cells or fluorescently labeled COVID RNA hybridization strands within the testes tissue Fluorescent-labeled tissue slides were imaged on a quantitative pathology scope with various zoom levels allowing for comprehensive qualitative and quantitative imaging Results: Among pathological examination of H&E stained slides from COVID-19 positive men, one case demonstrated increased inflammation and leukocyte infiltration, as well as occasional seminiferous tubules comprised of only Sertoli cells The other 2 showed no abnormal change These 2 cases had no leukocyte or macrophage infiltration, no inflammation, no abnormal basement membrane thickening, or changes to spermatogenesis There was little to no difference between the two COVID-19 positive cases and COVID-19 negative controls Sectioned slides from both COVID-19 positive as well as COVID-19 negative men are currently undergoing fluorescent labeled antibody staining for COVID RNA with results pending Conclusions: This study suggests that, despite the increase in ACE2 receptor presence in testes tissue and the SARS-CoV-2 virus’ propensity to bind to said receptor, the male reproductive tract may not be targets of COVID-19 infection in all men Whether COVID-19 RNA is detected in testes tissue remains to be evaluated
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