Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis

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. Testis tissue was collected from autopsies of COVID-19 positive (n=6) and negative men (n=3). Formalin-fixe...

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Published inThe world journal of men's health Vol. 39; no. 1; pp. 65 - 74
Main Authors Achua, Justin K., Chu, Kevin Y., Ibrahim, Emad, Khodamoradi, Kajal, Delma, Katiana S., Iakymenko, Oleksii A., Kryvenko, Oleksandr N., Arora, Himanshu, Ramasamy, Ranjith
Format Journal Article
LanguageEnglish
Published Korea (South) Korean Society for Sexual Medicine and Andrology 01.01.2021
대한남성과학회
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ISSN2287-4208
2287-4690
DOI10.5534/wjmh.200170

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Abstract 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. 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). 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. 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.
AbstractList 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.PURPOSETo 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.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).MATERIALS AND METHODSTestis 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).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.RESULTSH&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.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.CONCLUSIONSThe 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.
PurposeTo 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 MethodsTestis 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).ResultsH&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.ConclusionsThe 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.
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.
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. 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). 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. 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.
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. KCI Citation Count: 0
Author Arora, Himanshu
Ibrahim, Emad
Ramasamy, Ranjith
Chu, Kevin Y.
Iakymenko, Oleksii A.
Achua, Justin K.
Khodamoradi, Kajal
Delma, Katiana S.
Kryvenko, Oleksandr N.
AuthorAffiliation 2 Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL, USA
1 Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
3 The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
4 John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
AuthorAffiliation_xml – name: 1 Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
– name: 2 Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL, USA
– name: 3 The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
– name: 4 John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
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  givenname: Justin K.
  orcidid: 0000-0002-4159-439X
  surname: Achua
  fullname: Achua, Justin K.
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  orcidid: 0000-0003-1929-710X
  surname: Chu
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  organization: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
– sequence: 3
  givenname: Emad
  orcidid: 0000-0002-8862-535X
  surname: Ibrahim
  fullname: Ibrahim, Emad
  organization: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
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  givenname: Kajal
  orcidid: 0000-0003-2951-4382
  surname: Khodamoradi
  fullname: Khodamoradi, Kajal
  organization: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
– sequence: 5
  givenname: Katiana S.
  orcidid: 0000-0002-1733-6817
  surname: Delma
  fullname: Delma, Katiana S.
  organization: Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL, USA
– sequence: 6
  givenname: Oleksii A.
  orcidid: 0000-0003-1588-8965
  surname: Iakymenko
  fullname: Iakymenko, Oleksii A.
  organization: Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL, USA
– sequence: 7
  givenname: Oleksandr N.
  orcidid: 0000-0002-0116-7836
  surname: Kryvenko
  fullname: Kryvenko, Oleksandr N.
  organization: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA., Department of Pathology, Miller School of Medicine, University of Miami, Miami, FL, USA
– sequence: 8
  givenname: Himanshu
  orcidid: 0000-0003-3949-6763
  surname: Arora
  fullname: Arora, Himanshu
  organization: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA., The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL, USA., John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
– sequence: 9
  givenname: Ranjith
  orcidid: 0000-0003-1387-7904
  surname: Ramasamy
  fullname: Ramasamy, Ranjith
  organization: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA., The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33151050$$D View this record in MEDLINE/PubMed
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Copyright Copyright © 2021 Korean Society for Sexual Medicine and Andrology.
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Copyright © 2021 Korean Society for Sexual Medicine and Andrology 2021 Korean Society for Sexual Medicine and Andrology
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Issue 1
Keywords COVID-19
Testis
Coronavirus
Autopsy
Infertility
Language English
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Snippet To evaluate the presence and analyze the pathological changes within the testes of patients who died or recovered from severe acute respiratory syndrome...
PurposeTo evaluate the presence and analyze the pathological changes within the testes of patients who died or recovered from severe acute respiratory syndrome...
Purpose: To evaluate the presence and analyze the pathological changes within the testes of patients who died or recovered from severe acute respiratory...
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StartPage 65
SubjectTerms Androgens
Autopsies
autopsy
Biopsy
coronavirus
Coronaviruses
COVID-19
Disease control
Disease transmission
Enzymes
Infertility
Medical examiners
Microscopy
Original
Patients
Severe acute respiratory syndrome coronavirus 2
Spermatogenesis
Testes
testis
Viruses
비뇨기과학
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Title Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis
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