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. 2020 Dec 14;18(2):487–489. doi: 10.1038/s41423-020-00604-5

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© The Author(s), under exclusive licence to Springer Nature Limited part of Springer Nature 2020

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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Fig. 1 — Spermatogenesis damage was observed in COVID-19 patients. (a) Histological analyses of testicular sections from COVID-19 patients (patients 1, 2, 3, 4, and 5) and uninfected controls (controls 1, 2, and 3) showing numerous degenerated germ cells sloughing into the lumen of the seminiferous tubules of all five COVID-19 patients; normal spermatogenesis was observed in control patients. Spg spermatogonia, Spc spermatocytes, Sd spermatids, Spz spermatozoa, Sc Sertoli cells. Arrows indicate degenerated germ cells. Scale bar = 100 μm. Representative CD3 (b), CD20 (c), C68 (d), and human IgG (e) immunohistochemical staining images in the testicular sections of control and COVID-19 patients (patients 2, 3, and 4) are shown. Scale bar = 100 μm. The right upper image represents a magnified inset for each positive cell stain. (f) Representative SARS-CoV-2 spike protein immunohistochemical staining images in the testicular sections of control and COVID-19 patients (patients 1, 2, 3, 4, and 5) are shown. Black arrows indicate SARS-CoV-2 spike S1-positive cells. Scale bar = 100 μm. (g) Electron microscopy of the testis from COVID-19 patient 1, showing coronavirus-like particles suggestive of viral infection (viral particles are highlighted by blue arrows). (h) Representative ACE2 (upper panel) and TMPRSS2 (lower panel) immunohistochemical staining images in the testicular sections of a control and COVID-19 patient (patient 4) are shown. Black arrows indicate round spermatids; black arrowheads indicate pachytene spermatocytes; red arrows indicate Sertoli cells; red arrowheads indicate spermatogonia. Scale bar = 100 μm. RT-qPCR analyses of relative ACE2 (i) and TMPRSS2 (j) mRNA levels in controls (controls 1, 2, and 3) and COVID-19 patients (patients 1, 2, 3, 4, and 5). Each color bar represents one sample. (k) Heat map of genes significantly deregulated in the testes of COVID-19 patients compared to those in the testes of controls.