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      Semen Does Not Cause Additional Risk for SARS-CoV-2 Transmission during Sexual Contact


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          Dear Editor, We read the letter to the editor by V. Wiwanitkit with the title “SARS-CoV-2 in semen” [1]. The author emphasizes that even if semen has a very low possibility for transmission of the virus, the disease can be transmitted by the respiratory route due to the very close contact between partners. Actually, we think the same as the author. Transmission with respiratory secretions during sexual contact poses a much greater risk than the transmission through semen [2, 3]. We think that even if severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is detected in a patient's semen sample, it is quite difficult to say that the transmission between partners has solely been through semen. As the risk of transmission with respiratory secretion is clearly defined from the beginning of the pandemic, we did not have a need to emphasize this point. In our study, we only aimed to investigate the role of semen in disease transmission. The risk of respiratory contact or other risky behaviors that are revealed during sexual activity was not mentioned. Our study argues that there is probably no additional transmission risk via semen. The available data also support our study that SARS-CoV-2 is not a sexually transmitted virus [4, 5, 6, 7, 8]. However, sexual contact carries a high risk in terms of SARS-CoV-2 transmission between partners through the respiratory secretions, not semen. Conflict of Interest Statement There is no conflict of interest. Author Contributions All authors searched the literature and argued the text. Bircan Kayaaslan wrote the letter. All authors read and accepted the final version.

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          Most cited references8

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          Is Open Access

          Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019

          This cohort study examines the clinical characteristics of men with coronavirus disease 2019 whose semen tested positive for severe acute respiratory syndrome coronavirus 2.
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            Community Transmission of Severe Acute Respiratory Syndrome Coronavirus 2, Shenzhen, China, 2020

            Since early January 2020, after the outbreak of coronavirus infection in Wuhan, China, ≈365 confirmed cases have been reported in Shenzhen, China. The mode of community and intrafamily transmission is threatening residents in Shenzhen. Strategies to strengthen prevention and interruption of these transmissions should be urgently addressed.
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              Absence of SARS‐CoV‐2 in Semen of a COVID‐19 Patient Cohort

              Abstract Background Since SARS‐CoV‐2 infection was first identified in December 2019, the novel coronavirus‐induced pneumonia COVID‐19 spread rapidly and triggered a global pandemic. Recent bioinformatics evidence suggests that angiotensin converting enzyme 2—the main cell entry target of SARS‐CoV‐2—is predominantly enriched in spermatogonia, Leydig and Sertoli cells, which suggests the potential vulnerability of the male reproductive system to SARS‐CoV‐2 infection. Objectives To identify SARS‐CoV‐2 RNA in seminal plasma and to determine semen characteristics from male patients in the acute and recovery phases of infection. Methods From February 26 to April 2, 2020, 23 male patients with COVID‐19 were recruited. The clinical characteristics, laboratory findings and chest computed tomography scans of all patients were recorded in detail. We also investigated semen characteristics and the viral RNA load in semen from these patients in the acute and recovery phases of SARS‐CoV‐2 infection using approved methods. Results The age range of the 23 patients was 20–62 years. All patients tested negative for SARS‐CoV‐2 RNA in semen specimens. Among them, the virus had been cleared in 11 patients, as they tested negative. The remaining 12 patients tested negative for SARS‐CoV‐2 RNA in semen samples, but were positive in sputum and fecal specimens. The median interval from diagnosis to providing semen samples was 32 days, when total sperm counts, total motile sperm counts and sperm morphology of the patients were within normal ranges. Discussion and Conclusion In this cohort of patients with a recent infection or recovering from COVID‐19, there was no SARS‐CoV‐2 RNA detected in semen samples, which indicates the unlikely possibility of sexual transmission through semen at about 1 month after first detection.

                Author and article information

                Urol Int
                Urol Int
                Urologia Internationalis
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH-4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                16 October 2020
                : 1-2
                [1] aInfectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey
                [2] bClinical Microbiology, Virology, National Virology Laboratory, Turkish Public Health Institution, Ankara, Turkey
                [3] cInfectious Disease and Clinical Microbiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
                Author notes
                *Bircan Kayaaslan, Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Bilkent Street No. 1, TR–06800 Ankara (Turkey), drbican@ 123456gmail.com
                Copyright © 2020 by S. Karger AG, Basel

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                : 8 September 2020
                : 11 September 2020
                Page count
                References: 8, Pages: 2
                Letter to the Editor


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