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- Title
Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis.
- Authors
Achua, Justin K.; Chu, Kevin Y.; Ibrahim, Emad; Khodamoradi, Kajal; Delma, Katiana S.; Iakymenko, Oleksii A.; Kryvenko, Oleksandr N.; Arora, Himanshu; Ramasamy, Ranjith
- Abstract
Purpose: To evaluate the presence and analyze the pathological changes within the testes of patients who died or recovered from severe acute respiratory syndrome coronavirus 2 (COVID-19) complications. Materials and Methods: Testis tissue was collected from autopsies of COVID-19 positive (n=6) and negative men (n=3). Formalin-fixed paraffin-embedded tissues were stained with hematoxylin and eosin (H&E) and subjected to immunofluorescence for angiotensin-converting enzyme 2 (ACE-2) expression. Fluorescent-labeled tissue slides were imaged on a quantitative pathology scope with various zoom levels allowing for qualitative and quantitative interpretation. Tissue from four COVID-19 positive autopsy cases and a live seroconverted patient was imaged with transmission electron microscopy (TEM). Results: H&E histomorphology showed three of the six COVID-19 biopsies had normal spermatogenesis while the remaining three had impaired spermatogenesis. TEM showed the COVID-19 virus in testis tissue of one COVID-19 positive autopsy case and the live biopsy, H&E stain on the same autopsy case demonstrated interstitial macrophage and leukocyte infiltration. Immunofluorescent stained slides from six COVID-19 positive men demonstrated a direct association between increased quantitative ACE-2 levels and impairment of spermatogenesis. Conclusions: The novel COVID-19 has an affinity for ACE-2 receptors. Since ACE-2 receptor expression is high in the testes, we hypothesized that COVID-19 is prevalent in testes tissue of infected patients. This study suggests the male reproductive tract, specifically the testes, may be targets of COVID-19 infection. We found an inverse association between ACE-2 receptor levels and spermatogenesis, suggesting a possible mechanism of how COVID-19 can cause infertility.
- Subjects
COVID-19 pandemic; HISTOPATHOLOGY; ULTRASTRUCTURE (Biology); IMMUNOFLUORESCENCE; TRANSMISSION electron microscopy
- Publication
World Journal of Men's Health, 2021, Vol 39, Issue 1, p65
- ISSN
2287-4208
- Publication type
Article
- DOI
10.5534/wjmh.200170