The significance of coronavirus infection in the development of reproductive and lower urinary tract lesions
The effect of COVID-19 on the organs of the genitourinary system, about which not much information is available today, is of particular interest to urologists.
Research studies are continuously developing and require extensive analysis of data in order to establish long-term complications, persisting changes in physiology parameters and anatomical and histological variables, as well as establishing the possibility of reversing these changes.
Moreover, the results obtained will not only improve the quality of diagnosis, treatment, and prevention of Coronavirus infection and its complication, but also increase our understanding of the ways to prevent or minimize the degree of these complications and changes.
This article reviews the impact of COVID-19 on the genitourinary system, in particular its role in the development of lesions of the lower urinary tract and the reproductive system, as well as the role of androgens in SARS-CoV-2.
Coronavirus infection can be felt in all organs and systems, either directly through the virus itself itself, attacking the cells or indirectly through the virus’ indirect effects on cells and tissues.
A coronavirus infection affects the entire body, and the severity of the damage and associated complications do not always correlate with the severity of the infection.
It can be difficult to detect coronavirus infection in some patients because their symptoms are asymptomatic or mild, which may lead patients to miss out on treatment and prevention, and they may not conduct diagnostic measures once they are well enough to identify complications early.
SARS-CoV-2 has already been shown to affect testosterone levels and testicular hemodynamics. A drop in Ts was discovered in comparison to the original value, as well as a degradation in the blood flow of the testicles, during a complete examination that included the investigation of the level of total testosterone (Ts) in the blood serum and hemodynamic parameters of the testicles.
The results show that coronavirus infection has a long-term effect on the reproductive system that persists 6 months after recovery and that in certain individuals, a progression of a decline in the examined parameters is observed.
SARS-CoV-2 enhances cardiovascular system involvement in systemic damage, as well as endothelial damage, endothelial dysfunction, and perivascular inflammation, which exacerbates endothelial damage and leads to systemic microcirculation disturbance in numerous organs.
Papillomaviruses had previously been implicated in the etiology of chronic recurrent cystitis (CRC) and infertility, which is particularly common among women of reproductive age. The bacterium-viral microbiota of urine has also been discovered.
To date, the involvement of herpes, cytomegalovirus and PVI infections in the development of CRC have been studied and proven. But now the question of studying the effect of coronavirus infection on the organs of the urinary and reproductive system is more acute.
It was also found that the heart, ileum, esophagus, bladder, kidneys, and testicles have ACE-2-positive cells, which explains the frequent acute damage to the above organs during coronavirus infection.
The severity of coronavirus infection is known to be directly related to inflammation and increased levels of inflammatory cytokines. Studies have shown an increase in the level of inflammatory cytokines IL-6, IL-8 and IL-10 in the urine compared to the control group.
Thus, the authors confirm the possibility of developing COVID-19 associated cystitis. A new coronavirus infection and its complications are a complex and unsolved problem of modern medicine, affecting the respiratory, hemodynamic, immunocompetent structures.
Full text of the article: Ibishev Kh.S., Atadzhanova A.T., Mamedov E.A., Vasilyev O.N. The significance of coronavirus infection in the development of reproductive and lower urinary tract lesions. Vestnik Urologii. 2021;9(2):125-131. (In Russ.).