Understanding SARS-CoV-2 infection in males

Abstract

The worldwide spread of the emerging respiratory disease produced by SARS-CoV-2 has become a matter of great concern to public health. The expression of the viral receptor ACE2 in the male reproductive tract arises hypothesis about a possible targeting to testicular tissue during the infection and further implications to male fertility. However, current data of whether the virus is present or not in the seminal fluid is contrasting. Objectives: The propose of this opinion article was to describe the impact SARS-CoV-2 infection in males. We analyze SARS-CoV-2 infection and the sex differential epidemiological impact in 3 185 468 cases from 53 countries. Although men and women seem equally susceptible to infection, SARS-CoV-2 elicits worsening outcomes in males; the mean proportion of deaths in confirmed cases (male:female ratio) is 1.5 (95% CI: 1.39 – 1.62). To date, evidence shows that the stronger inflammatory response in men is a marker of disease severity and mortality, and systemic inflammation might be correlated to the altered hormone profile in male patients. More high-quality information regarding the pathophysiology of the infection and gender disparity is needed to understand the higher mortality rates in men.