{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:18:15Z","timestamp":1792091895990,"version":"4.4.0"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:00:00Z","timestamp":1689033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003074","name":"Agencia Nacional de Promoci\u00f3n Cient\u00edfica y Tecnol\u00f3gica","doi-asserted-by":"publisher","award":["PICT 2019-2451 PICT 2018-3004"],"award-info":[{"award-number":["PICT 2019-2451 PICT 2018-3004"]}],"id":[{"id":"10.13039\/501100003074","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002923","name":"Consejo Nacional de Investigaciones Cient\u00edficas y T\u00e9cnicas","doi-asserted-by":"publisher","award":["PIP 11220200103254CO PGD 22920160100116CO P-UE 22920160100116CO"],"award-info":[{"award-number":["PIP 11220200103254CO PGD 22920160100116CO P-UE 22920160100116CO"]}],"id":[{"id":"10.13039\/501100002923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012478","name":"Secretaria de Ciencia y Tecnolog\u00eda\u2014Universidad Nacional de C\u00f3rdoba","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> COVID-19 exerts deleterious effects on the respiratory, cardiovascular, gastrointestinal, and central nervous systems, causing more severe disease in men than in women. However, cumulative reported data about the putative consequences on the male reproductive tract and fertility are controversial. Furthermore, the long-term effects of SARS-CoV-2 infection are still uncertain.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> In this study, we prospectively evaluated levels of inflammatory cytokines and leukocytes in semen and sperm quality parameters in a cohort of 231 reproductive-aged male patients, unvaccinated, who had recovered from mild or severe COVID-19 and in 62 healthy control individuals. Sperm quality was assessed early (less than 3 months) and long (more than 3 and up to 6\u00a0months) after having COVID-19. Interestingly, and unlike most reported studies, available extensive background and baseline data on patients\u2019 sperm quality allowed performing a more accurate analysis of COVID-19 effects on sperm quality.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Significantly higher levels of IL-1\u03b2, TNF and IFN\u03b3 were detected in semen from patients recently recovered from mild and\/or severe COVID-19 with respect to control individuals indicating semen inflammation. Moreover, patients recovered from mild and\/or severe COVID-19 showed significantly reduced semen volume, lower total sperm counts, and impaired sperm motility and viability. Interestingly, all observed alterations returned to baseline values after 3 or more months after disease recovery.<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> These results indicate that COVID-19 associates with semen inflammation and impaired semen quality early after disease. However, long COVID-19 seems not to include long-term detrimental consequences on male fertility potential since the observed alterations were reversible after 1-2 spermatogenesis cycles. These data constitute compelling evidence allowing a better understanding of COVID-19 associated sequelae, fundamental for semen collection in assisted reproduction.<\/jats:p>","DOI":"10.3389\/fphys.2023.1220048","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T04:31:00Z","timestamp":1689049860000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":26,"title":["COVID-19 associates with semen inflammation and sperm quality impairment that reverses in the short term after disease recovery"],"prefix":"10.3389","volume":"14","author":[{"given":"Mar\u00eda Sol","family":"Martinez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Nicol\u00e1s","family":"Ferreyra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Andrea","family":"Paira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia Elena","family":"Rivero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Javier","family":"Olmedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Daniela","family":"Tissera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Isabel","family":"Molina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n Dar\u00edo","family":"Motrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"5201","DOI":"10.1002\/jmv.27971","article-title":"Investigation of the effect of COVID-19 on sperm count, motility, and morphology","volume":"94","author":"Aksak","year":"2022","journal-title":"J. Med. Virol."},{"key":"B2","volume-title":"COVID-19. SITUACI\u00d3N DE NUEVAS VARIANTES SARS-CoV-2 EN ARGENTINA. SE32\/2021. INFORME T\u00c9CNICO","author":"Argentina","year":"2021"},{"key":"B3","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1093\/humupd\/dmac037","article-title":"SARS-CoV-2, fertility and assisted reproduction","volume":"29","author":"Ata","year":"2022","journal-title":"Hum. Reprod. Update"},{"key":"B4","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.ucl.2013.08.008","article-title":"Infectious, inflammatory, and immunologic conditions resulting in male infertility","volume":"41","author":"Bachir","year":"2014","journal-title":"Urol. Clin. North Am."},{"key":"B5","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/S0140-6736(22)01214-4","article-title":"Persistence of somatic symptoms after COVID-19 in The Netherlands: An observational cohort study","volume":"400","author":"Ballering","year":"2022","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1989","DOI":"10.1016\/j.mayocp.2020.06.018","article-title":"Targeting TMPRSS2 in SARS-CoV-2 infection","volume":"95","author":"Baughn","year":"2020","journal-title":"Mayo Clin. Proc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1111\/andr.13037","article-title":"Current status of the COVID-19 and male reproduction: A review of the literature","volume":"9","author":"Borges","year":"2021","journal-title":"Andrology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1038\/s41577-020-0308-3","article-title":"COVID-19: Immunopathology and its implications for therapy","volume":"20","author":"Cao","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"382","DOI":"10.4103\/aja202250","article-title":"Effects of mild\/asymptomatic COVID-19 on semen parameters and sex-related hormone levels in men: A systematic review and meta-analysis","volume":"25","author":"Che","year":"2022","journal-title":"Asian J. Androl."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1002\/jum.15558","article-title":"Ultrasound imaging findings of acute testicular infection in patients with coronavirus disease 2019: A single-center-based study in wuhan, China","volume":"40","author":"Chen","year":"2021","journal-title":"J. Ultrasound Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.1007\/s40618-022-01801-x","article-title":"Andrological effects of SARS-cov-2 infection: A systematic review and meta-analysis","volume":"45","author":"Corona","year":"2022","journal-title":"J. Endocrinol. Invest."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s40618-023-02055-x","article-title":"SARS-CoV-2 and male infertility: From short-to long-term impacts","author":"Dai","year":"2023","journal-title":"J. Endocrinol. Invest."},{"key":"B13","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long COVID: Major findings, mechanisms and recommendations","volume":"21","author":"Davis","year":"2023","journal-title":"Nat. Rev. Microbiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.fertnstert.2021.10.022","article-title":"Sperm quality and absence of SARS-CoV-2 RNA in semen after COVID-19 infection: A prospective, observational study and validation of the SpermCOVID test","volume":"117","author":"Donders","year":"2022","journal-title":"Fertil. Steril."},{"key":"B15","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s43043-022-00115-5","article-title":"Correspondence: Semen parameters in men who recovered from Covid-19 - a systematic review and meta-analysis","volume":"27","author":"Dos Santos","year":"2022","journal-title":"Middle East Fertil. Soc. J."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1111\/andr.13019","article-title":"Short-term effects of COVID-19 on semen parameters: A multicenter study of 69 cases","volume":"9","author":"Erbay","year":"2021","journal-title":"Andrology"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e14609","DOI":"10.1111\/and.14609","article-title":"Examining changes on testicular structure and sperm analysis of COVID-19 patients","volume":"54","author":"Ertas","year":"2022","journal-title":"Andrologia"},{"key":"B18","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1071\/RD21153","article-title":"Effects of moderate COVID-19 infection on semen oxidative status and parameters 14 and 120 days after diagnosis","volume":"33","author":"Falahieh","year":"2021","journal-title":"Reprod. Fertil. Dev."},{"key":"B19","doi-asserted-by":"publisher","first-page":"103183","DOI":"10.1016\/j.jri.2020.103183","article-title":"Bacterial infection of the male reproductive system causing infertility","volume":"142","author":"Farsimadan","year":"2020","journal-title":"J. Reprod. Immunol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"4383","DOI":"10.1007\/s11033-020-05478-4","article-title":"Expressions and significances of the angiotensin-converting enzyme 2 gene, the receptor of SARS-CoV-2 for COVID-19","volume":"47","author":"Fu","year":"2020","journal-title":"Mol. Biol. Rep."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1520","DOI":"10.1093\/humrep\/deab026","article-title":"Semen impairment and occurrence of SARS-CoV-2 virus in semen after recovery from COVID-19","volume":"36","author":"Gacci","year":"2021","journal-title":"Hum. Reprod."},{"key":"B22","doi-asserted-by":"publisher","first-page":"110","DOI":"10.21037\/tau-21-935","article-title":"Rapid impact of COVID-19 infection on semen quality: A case report","volume":"11","author":"Gharagozloo","year":"2022","journal-title":"Transl. Androl. Urol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"e1011409","DOI":"10.1371\/journal.ppat.1011409","article-title":"In vitro evidence against productive SARS-CoV-2 infection of human testicular cells: Bystander effects of infection mediate testicular injury","volume":"19","author":"Giannakopoulos","year":"2023","journal-title":"PLoS Pathog."},{"key":"B24","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1002\/jemt.20704","article-title":"Cytokines and chemokines in testicular inflammation: A brief review","volume":"72","author":"Guazzone","year":"2009","journal-title":"Microsc. Res. Tech."},{"key":"B25","doi-asserted-by":"publisher","first-page":"479","DOI":"10.4103\/aja.aja_31_21","article-title":"Semen parameters in men recovered from COVID-19","volume":"23","author":"Guo","year":"2021","journal-title":"Asian J. Androl."},{"key":"B26","doi-asserted-by":"publisher","first-page":"331","DOI":"10.4103\/iju.iju_117_21","article-title":"Detection of SARS-CoV2 virus using the real-time reverse transcriptase polymerase chain reaction in semen and seminal plasma from men with active COVID-19 infection - a pilot study","volume":"37","author":"Gupta","year":"2021","journal-title":"Indian J. Urol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e13883","DOI":"10.1111\/and.13883","article-title":"Potential mechanisms of SARS-CoV-2 action on male gonadal function and fertility: Current status and future prospects","volume":"53","author":"Haghpanah","year":"2021","journal-title":"Andrologia"},{"key":"B28","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.1016\/j.mayocp.2020.07.024","article-title":"COVID-19 and sex differences: Mechanisms and biomarkers","volume":"95","author":"Haitao","year":"2020","journal-title":"Mayo Clin. Proc."},{"key":"B29","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1530\/REP-20-0382","article-title":"COVID-19 and male reproductive function: A prospective, longitudinal cohort study","volume":"161","author":"Hajizadeh Maleki","year":"2021","journal-title":"Reproduction"},{"key":"B30","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.cell.2020.02.052","article-title":"SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor","volume":"181","author":"Hoffmann","year":"2020","journal-title":"Cell"},{"key":"B31","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.fertnstert.2020.05.028","article-title":"Assessment of SARS-CoV-2 in human semen-a cohort study","volume":"114","author":"Holtmann","year":"2020","journal-title":"Fertil. Steril."},{"key":"B32","doi-asserted-by":"publisher","first-page":"159","DOI":"10.21037\/tau-21-922","article-title":"Evaluation of mid- and long-term impact of COVID-19 on male fertility through evaluating semen parameters","volume":"11","author":"Hu","year":"2022","journal-title":"Transl. Androl. Urol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1070692","DOI":"10.3389\/fendo.2023.1070692","article-title":"Unraveling the harmful effect of oxidative stress on male fertility: A mechanistic insight","volume":"14","author":"Hussain","year":"2023","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B34","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1159\/000517276","article-title":"Does COVID-19 worsen the semen parameters? Early results of a tertiary healthcare center","volume":"105","author":"Koc","year":"2021","journal-title":"Urol. Int."},{"key":"B35","doi-asserted-by":"publisher","first-page":"100604","DOI":"10.1016\/j.eclinm.2020.100604","article-title":"Impaired spermatogenesis in COVID-19 patients","volume":"28","author":"Li","year":"2020","journal-title":"EClinicalMedicine"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.3390\/jcm11061541","article-title":"Prognostic factors for post-COVID-19 syndrome: A systematic review and meta-analysis","volume":"11","author":"Maglietta","year":"2022","journal-title":"J. Clin. Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1111\/andr.13138","article-title":"Male reproductive system inflammation after healing from coronavirus disease 2019","volume":"10","author":"Morselli","year":"2022","journal-title":"Andrology"},{"key":"B38","doi-asserted-by":"publisher","first-page":"957","DOI":"10.4049\/jimmunol.177.2.957","article-title":"Pathogenic consequences in semen quality of an autoimmune response against the prostate gland: From animal models to human disease","volume":"177","author":"Motrich","year":"2006","journal-title":"J. Immunol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1111\/bju.15573","article-title":"Impact of the SARS-CoV-2 virus on male reproductive health","volume":"129","author":"Nassau","year":"2022","journal-title":"BJU Int."},{"key":"B40","unstructured":"Coronavirus pandemic (COVID-19)\n            OurWorldinDataG. C. D. L.\n          2023"},{"key":"B41","doi-asserted-by":"publisher","first-page":"155834","DOI":"10.1016\/j.cyto.2022.155834","article-title":"Interferon \u03b3, IL-17, and IL-1\u03b2 impair sperm motility and viability and induce sperm apoptosis","volume":"152","author":"Paira","year":"2022","journal-title":"Cytokine"},{"key":"B42","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s40618-022-01887-3","article-title":"Male reproductive health after 3 months from SARS-CoV-2 infection: A multicentric study","volume":"46","author":"Paoli","year":"2023","journal-title":"J. Endocrinol. Invest."},{"key":"B43","doi-asserted-by":"publisher","first-page":"2675","DOI":"10.1007\/s40618-021-01580-x","article-title":"Molecular diagnosis of SARS-CoV-2 in seminal fluid","volume":"44","author":"Paoli","year":"2021","journal-title":"J. Endocrinol. Invest."},{"key":"B44","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1016\/j.fertnstert.2020.12.033","article-title":"The impact of SARS-CoV-2 and COVID-19 on male reproduction and men's health","volume":"115","author":"Patel","year":"2021","journal-title":"Fertil. Steril."},{"key":"B45","doi-asserted-by":"publisher","first-page":"e14157","DOI":"10.1111\/and.14157","article-title":"Impaired semen parameters in patients with confirmed SARS-CoV-2 infection: A prospective cohort study","volume":"53","author":"Pazir","year":"2021","journal-title":"Andrologia"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1159\/000513346","article-title":"Sex disparities in COVID-19 severity and outcome: Are men weaker or women stronger?","volume":"111","author":"Pivonello","year":"2021","journal-title":"Neuroendocrinology"},{"key":"B47","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1016\/s0015-0282(16)56116-0","article-title":"Comparison of methods to enumerate white blood cells in semen","volume":"60","author":"Politch","year":"1993","journal-title":"Fertil. Steril."},{"key":"B48","doi-asserted-by":"publisher","first-page":"284","DOI":"10.3390\/ijerph18010284","article-title":"The scRNA-seq expression profiling of the receptor ACE2 and the cellular protease TMPRSS2 reveals human organs susceptible to SARS-CoV-2 infection","volume":"18","author":"Qi","year":"2021","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B49","doi-asserted-by":"publisher","first-page":"104413","DOI":"10.1016\/j.ebiom.2022.104413","article-title":"Generalisable long COVID subtypes: Findings from the NIH N3C and RECOVER programmes","volume":"87","author":"Reese","year":"2023","journal-title":"EBioMedicine"},{"key":"B50","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1111\/andr.12939","article-title":"No detection of SARS-CoV-2 from urine, expressed prostatic secretions, and semen in 74 recovered COVID-19 male patients: A perspective and urogenital evaluation","volume":"9","author":"Ruan","year":"2021","journal-title":"Andrology"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1111\/andr.12993","article-title":"Severely low testosterone in males with COVID-19: A case-control study","volume":"9","author":"Salonia","year":"2021","journal-title":"Andrology"},{"key":"B52","doi-asserted-by":"publisher","first-page":"2703","DOI":"10.1007\/s43032-022-00975-2","article-title":"A case of asthenozoospermia following COVID-19 infection","volume":"29","author":"Seckin","year":"2022","journal-title":"Reprod. Sci."},{"key":"B53","doi-asserted-by":"publisher","first-page":"10060","DOI":"10.3390\/ijms231710060","article-title":"Oxidative stress markers and sperm DNA fragmentation in men recovered from COVID-19","volume":"23","author":"Shcherbitskaia","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"B54","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.fertnstert.2020.05.001","article-title":"Coronavirus disease-19 and fertility: Viral host entry protein expression in male and female reproductive tissues","volume":"114","author":"Stanley","year":"2020","journal-title":"Fertil. Steril."},{"key":"B55","doi-asserted-by":"publisher","first-page":"e13912","DOI":"10.1111\/and.13912","article-title":"Investigation of SARS-CoV-2 in semen samples and the effects of COVID-19 on male sexual health by using semen analysis and serum male hormone profile: A cross-sectional, pilot study","volume":"53","author":"Temiz","year":"2021","journal-title":"Andrologia"},{"key":"B56","doi-asserted-by":"publisher","first-page":"e745","DOI":"10.1002\/hsr2.745","article-title":"Semen parameters after SARS-CoV-2 infection: A literature review","volume":"5","author":"Tufvesson","year":"2022","journal-title":"Health Sci. Rep."},{"key":"B57","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1007\/s12015-020-09976-7","article-title":"CD147 as a target for COVID-19 treatment: Suggested effects of azithromycin and stem cell engagement","volume":"16","author":"Ulrich","year":"2020","journal-title":"Stem Cell Rev. Rep."},{"key":"B58","doi-asserted-by":"publisher","first-page":"2709","DOI":"10.1093\/humrep\/deab183","article-title":"Single-cell RNA sequencing of SARS-CoV-2 cell entry factors in the preconceptional human endometrium","volume":"36","author":"Vilella","year":"2021","journal-title":"Hum. Reprod."},{"key":"B59","doi-asserted-by":"publisher","first-page":"981471","DOI":"10.3389\/fgene.2022.981471","article-title":"COVID-19 inhibits spermatogenesis in the testes by inducing cellular senescence","volume":"13","author":"Wang","year":"2022","journal-title":"Front. Genet."},{"key":"B60","doi-asserted-by":"publisher","first-page":"920","DOI":"10.3390\/cells9040920","article-title":"scRNA-seq profiling of human testes reveals the presence of the ACE2 receptor, A target for SARS-CoV-2 infection in spermatogonia, Leydig and Sertoli cells","volume":"9","author":"Wang","year":"2020","journal-title":"Cells"},{"key":"B61","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/978-3-540-78355-8_2","article-title":"Physiology of testicular function","volume-title":"Andrology: Male reproductive health and dysfunction","author":"Weinbauer","year":"2010"},{"key":"B62","volume-title":"World Health Organization laboratory manual for the examination of human semen and semen-cervical mucus interaction","author":"Who","year":"2010"},{"key":"B63","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1007\/s10815-022-02540-x","article-title":"SARS-CoV-2 effects on sperm parameters: A meta-analysis study","volume":"39","author":"Xie","year":"2022","journal-title":"J. Assist. Reprod. Genet."},{"key":"B64","doi-asserted-by":"publisher","first-page":"651408","DOI":"10.3389\/fphys.2021.651408","article-title":"Severe acute respiratory syndrome coronavirus 2 and male reproduction: Relationship, explanations, and clinical remedies","volume":"12","author":"Xu","year":"2021","journal-title":"Front. Physiol."},{"key":"B65","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1016\/j.euf.2020.05.009","article-title":"Pathological findings in the testes of COVID-19 patients: Clinical implications","volume":"6","author":"Yang","year":"2020","journal-title":"Eur. Urol. Focus"},{"key":"B66","doi-asserted-by":"publisher","first-page":"175","DOI":"10.3390\/v15010175","article-title":"Risk factors of severe COVID-19: A review of host, viral and environmental factors","volume":"15","author":"Zsichla","year":"2023","journal-title":"Viruses"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1220048\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T04:31:09Z","timestamp":1689049869000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2023.1220048\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,11]]},"references-count":66,"alternative-id":["10.3389\/fphys.2023.1220048"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2023.1220048","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,11]]},"article-number":"1220048"}}