For men, Covid-19 could spell doom in the bedroom

It has been over a year since Covid-19 was first identified in China, and nine months since Kenya’s patient zero was diagnosed. In this entire time, as we coin new phrases to address our new reality, the commonest one in the scientific community remains, “We still do not know enough about this virus, but…”

And discover new things we have. The pandemic has unreasonably punished the male gender a lot more than it has the female. Just when our counterparts could not take any more bleak news, in comes even worse news. Covid-19 seems all set to cause long-term damage to the male reproductive system and function.

Evidence has shown that the virus is attracted to certain cells in our bodies because these cells have a special protein called angiotensin-converting enzyme-2 (Ace-2) receptor. The virus binds to this Ace-2 receptor and uses it to enter the cells and cause damage. Therefore, organs that have this special protein are most prone to attack, such as the lungs, heart and yes, the testis.

Post-Covid-19 infertility and erectile dysfunction are a real threat. An article published in the Journal of Endocrinological Investigation by Sansone and others in June concludes that the virus seems to bear great capacity to threaten the security of our future generations.

In October, an Israeli study by Aderka found that 13 per cent of male Covid-19 patients had the virus in their sperm. Whether they can transmit this virus sexually or not is subject to further study.

Cells die off

A study carried out in China and published last month by Honggang L et al looked at the autopsy results of men who succumbed to the virus and also assessed those who had recovered from the condition and the findings were not pretty.

The virus has clearly demonstrated that it can put up a well-orchestrated attack on the testicular tissue, resulting in inflammation, oedema and damage to the cells of the blood vessels within the testis, causing them to be leaky and breach what is called the blood-testis barrier.

This barrier is important in maintaining a protected, suitable environment for the development and maturation of sperm.

The virus also appears to attack leydig cells, which are responsible for the manufacture of testosterone. Testosterone is the male hormone responsible for control of libido, erectile function, sperm manufacture, building muscle and bone mass. Essentially, it fuels the maleness-maintaining functions in the body.

The testicular autopsy studies and biopsies of male survivors of Covid-19 demonstrated disturbing findings. The seminiferous tubules, which are the basic functional units of the testis, are the incubators where sperm develop and mature. In these specimens, these tubules appeared thinner than normal.

Further, they had a higher number of cells that are naturally selected to die off in any process of manufacturing new cells; a process known as apoptosis. This means there are less numbers of immature sperms destined to mature.

This is further demonstrated when semen samples were taken from the Covid-19 survivors for analysis. A total of 39 per cent had lower than normal sperm counts, while 60 per cent showed a significant increase in the number of white blood cells and other immune modulators that should not be there in the first place.

In its conclusion, the study demonstrated that the virus appeared to directly attack the testicular tissue. In addition, the immune response provoked by the presence of the virus, causes even more damage to the tissue and this injury may persist long after the infection has cleared.

Damage to blood vessels

This ability of the virus to provoke our immune system to attack the body tissue while attempting to clear the virus, is what is causing the severe disease we see in some patients. The immune cells and chemicals seem to have a special preference for the inner lining of blood vessels, the endothelium. This means their attack on the endothelium affects the whole body as blood vessels are all over. The smaller the vessel, the worse the damage.

This vessel damage has a highly undesirable effect in organs such as the kidney and yes, the penile shaft where an erection relies on filling up of thousands of small blood vessels. Destroying these vessels means kissing your erection goodbye, an experience well understood by many men who have suffered long-standing diabetes.

While the damage to the process of sperm formation appears reversible, the damage to blood vessels in the penile shaft does not appear to. Simply put, one may be able to recover their sperm count, but not their erectile function.

This puts a whole lot more meaning to the Pfizer vaccine meme: In Pfizer we trust; if it can resurrect the dead, surely it can keep the living alive.

Maybe, just maybe, men will pay better attention to the public health measures because they are the only ones standing between Covid-19 and the future of man.