الفهرس 
Title : Effect of SARS-CoV-2 infection on testicular functions: a case- control study
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Abstract
Background: coronavirus disease 2019) COVID-19(is caused by a betacorona
virus which is now named SARS-CoV-2 due to its high sequence
similarity (" ~ "80%) with SARS-CoV.
Aim and objectives; to evaluate the effect of COVID-19 infection on
testicular function in terms of conventional semen parameters and
regulating hormones and how long will this effect last.
Subjects and methods: This study was carried out on male patients who
recently recovered from covid 19 infection aged between 18 and years at
the Andrology department at the Faculty of Medicine, Cairo University.
The control group was recruited from the age and fertility status matched
healthy population. Patients were compared to healthy controls due to a
lack of baseline data for infected participants. we assessed semen analysis
and hormonal profile for covid and control cases and follow-up for covid
cases for 6 months after recovery The effect of SARS COV 2 on seminal
and hormonal parameters can be concluded from statistically significant
differences between both groups. The number of control cases was 120.
Covid 19 cases were 76 cases subdivided according to the severity of
covid symptoms into mild and moderate: the number of mild cases was
33, number of moderate cases was 42.
Results: This study reveals a decrease in sperm concentration, total
motility and progressive motility and a significant increase in abnormal
forms in the moderate group compered to control group, A significant
decrease in total and progressive motility and a significant increase in
abnormal forms in the mild group compared to control group. There was
a significant increase in sperm concentration and total motility after 3
months compared to baseline semen analysis parameters in the moderate
group. There was a significant increase in sperm concentration after 6
months compared to baseline sperm concentration and 3 months sperm
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concentration in the moderate group. There was significant increase in
total motility after 6 months compared to baseline semen analysis in
moderate group. There was significant increase in sperm concentration
after 3 months and after 6 months compared to baseline sperm
concentration in the mild group. At baseline, 6 patients were with
azoospermic. After 3 months, 5 patients were azoospermic. After 6
months, 2 patients still azoospermic. Percentage of azoospermic patients
decreased by 33.3%.75% of moderate group improved in sperm
concentration after 3 months but only 27% of them returned to normal
values compared to baseline semen analysis . After 6 months 90.9%
improved but only 36.6 % return to normal values . To sum up, 54.5 % of
moderate group improved after 6 months but did not return to normal
sperm concentration values. There was a significant decrease in LH and
Tt in the mild group than in the control. There was a significant increase
in FSH and E2 in the moderate group compared to the control group.
In the moderate group, TT was significantly lower in the (D-R) group
compared to (D-H-E) and (D -H-I-E) groups by 41 % and 33.2%
respectively. Sperm concentration was significantly lower in the (D-H-E)
and (D-H-I-E) groups compared to(D-R) and (D-R-E)groups. And a
decrease in sperm concentration was more pronounced in (D-H-I-E)
group than in the (D-H-E) group. Abnormal forms were significantly
higher in (D-R) and (D-R-E) groups compared to (D-H-I-E). And after 3
months, Sperm concentration was significantly lower in(D-H-I-E) group
compared to the (D-R-E) group by 83.1%. After 6 months, the Sperm
concentration in (D-H-I-E) group was significantly lower compared to the
(D-H-E) group.
Conclusion: COVID-19 significantly affects male hormone levels and
sperm quality early after recovery mainly in moderate covid cases.
However, in patients with moderate disease, the studied parameters of the
testicular function improved within 6 months, but they did not return to
normal values. patients who used Ivermectin had the lowest sperm
concentration compared to other drugs and improved slower than other
groups and they did not return to normal sperm concentration value.