Article 2026-04-21 posted v1

SARS-CoV-2 infection reduces the number of spermatogonial stem cells and dysregulates the transcriptional landscape of the human testis

M
Miguel Brieno-Enriquez University of Pittsburgh School of Medicine
M
Maria López-Panadés1 Genome Integrity and Instability Research Group, Institut de Biotecnologia i Biomedicina (IBB), Universitat Autònoma de Barcelona, Spain
A
Ana Martinez-Marchal Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA
E
Esther Choi Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA
A
Andrew Levy Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA
T
Tianjiao Chu Magee-Womens Research Institute
S
Shruthi Shivkumar Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA
J
Justin Bochter Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.
J
Juan Morales Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.
P
Patrick Walsh Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.
M
Marta Martin-Ruiz Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.
G
Gretchen Rosado Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.
J
Jimmaline Hardy Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.
Y
Yang Hu Weill Cornell Medicine
J
Jiefei Wang University of Pittsburgh
C
Cristina Madrid-Sandín Genome Integrity and Instability Research Group, Institut de Biotecnologia i Biomedicina (IBB), Universitat Autònoma de Barcelona, Spain.
A
Andros Maldonado-Linares Universitat Autònoma de Barcelona
L
Lidia Yang Genome Integrity and Instability Research Group, Institut de Biotecnologia i Biomedicina (IBB), Universitat Autònoma de Barcelona, Spain.
È
Èlia Ramos-Ramells Genome Integrity and Instability Research Group, Institut de Biotecnologia i Biomedicina (IBB), Universitat Autònoma de Barcelona, Spain.
L
Lisa Barton Office of the Chief Medical Examiner, Oklahoma City, USA
E
Eric Duval Office of the Chief Medical Examiner, Oklahoma City, USA
E
Edana Stroberg Office of the Chief Medical Examiner, Oklahoma City, USA
S
Sanjay Mukhopadhyay Office of the Chief Medical Examiner, Oklahoma City, USA
U
Uma R Chandran University of Pittsburgh School of Medicine
A
Amanda Colvin Zielen Magee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, USA.
K
Kyle Orwig University of Pittsburgh School of Medicine
O
Olivier Elemento Weill Cornell Medicine
C
Carmen Marquez Clinica Gravida, Barcelona, Spain
S
Subha Ghosh Department of Anatomical Pathology, Cleveland Clinic, Cleveland, USA
L
Lluis Bassas Andrology Department, Laboratory of Andrology and Sperm Bank, Fundació Puigvert, Barcelona, Spain.
G
Guilherme Costa Universidade Federal de Minas Gerais
I
Ignasi Roig Autonomous University of Barcelona

Abstract

SARS-CoV-2 coronavirus emerged in 2019, leading to the Coronavirus disease 2019 (COVID-19). Expression of viral entry factors such as ACE2 and TMPRSS2 is higher in the testis, particularly in Sertoli cells, Leydig cells, and spermatogonia. To understand COVID-19's impact on testicular cell populations and gene expression, we analyzed testicular tissue samples from 28 COVID-19 patients and compared them with 23 non-diseased controls. COVID-19 samples showed increased immune cell infiltration, thrombosis, and reduced numbers of testicular cells. There was a significant decrease in Sertoli cells and spermatogonial stem cells (SSC) among COVID-19 patients, associated with high levels of DNA damage and apoptosis in these cell types. To explore the pathways through which the virus affects testicular function, we profiled 112,657 single-nucleus transcriptomes from the testes of 4 COVID-19 patients and 4 controls. We found that COVID-19 infection alters multiple transcriptome clusters and induces a new COVID-19-specific cluster. To confirm that these transcriptome changes are COVID-19-specific, we compared our results with those from the brains of patients with COVID-19 and influenza. We observed an average of 144 dysregulated genes unique to COVID-19, regardless of tissue type. Lastly, we examined whether the SSC phenotype seen in fatal COVID-19 cases was also present in recovered patients. Indeed, recovered patients also exhibited high DNA damage and a reduced SSC population at 3, 6, and 12 months post-infection. Additionally, embryos derived from recovered patients’ sperm showed lower fertilization rates compared to control-derived embryos and fewer live births. Overall, our findings demonstrate that SARS-CoV-2 disrupts spermatogenesis, alters the transcriptional landscape, and affects human testicular architecture and function well after the acute phase of infection, with potential long-term consequences for male fertility.

Citation Information

@article{miguelbrienoenriquez2026,
  title={SARS-CoV-2 infection reduces the number of spermatogonial stem cells and dysregulates the transcriptional landscape of the human testis},
  author={Miguel Brieno-Enriquez and Maria López-Panadés1 and Ana Martinez-Marchal and Esther Choi and Andrew Levy and Tianjiao Chu and Shruthi Shivkumar and Justin Bochter and Juan Morales and Patrick Walsh and Marta Martin-Ruiz and Gretchen Rosado and Jimmaline Hardy and Yang Hu and Jiefei Wang and Cristina Madrid-Sandín and Andros Maldonado-Linares and Lidia Yang and Èlia Ramos-Ramells and Lisa Barton and Eric Duval and Edana Stroberg and Sanjay Mukhopadhyay and Uma R Chandran and Amanda Colvin Zielen and Kyle Orwig and Olivier Elemento and Carmen Marquez and Subha Ghosh and Lluis Bassas and Guilherme Costa and Ignasi Roig},
  journal={Research Square},
  year={2026},
  doi={https://doi.org/10.21203/rs.3.rs-9371895/v1}
}
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