Angiotensin Converting Enzyme 2 (ACE2) - A macromolecule and its impact on human reproduction during COVID-19 pandemic

Abstract

Coronavirus disease 2019 (COVID 19) is caused by severe acute respiratory syndrome novel coronavirus 2 (SARS-nCoV-2). It has been declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Since then, several researchers have worked/ are working on this virus by a multifactorial approach to finding out the mechanism of entry, transmission route, post-infection replication process, survival, and post-recovery utilities. As we know, SARS, MERS, and Zika viruses have affected human reproductive potentials, consequently, COVID 19 also can affect both men's and women's reproductive potential through ACE2 macromolecule. This study aimed to summarize the role of ACE2- macromolecule in COVID 19 entry and further processes in the reproductive path of both men and women. Research articles were searched in NCBI-NLM, Google Scholar, and Scopus databases. We searched based on the phrase “COVID 19”, “ACE2”, “ACE2 in testes”, “ACE2 in the female reproductive tract”, “ACE2 during pregnancy”, “ACE2 during early embryo”, “COVID 19 and impact in human reproduction” and selected the articles for summarizing this article. Most recent articles and the mechanism of COVID 19 were selected for our understanding. The results of the study revealed that  COVID 19 impacts the reproductive potential of both men and women. Testes are the most vulnerable organ prone to infection in men, and vaginal fluid and the uterus could be the choice of infection in the female. Till now, COVID 19 has not been directly detected in semen samples and vaginal fluid. Results of the study can be concluded that ACE2 plays a major role in COVID 19 infection, ACE2 expression could be more in the testes, ovary, uterus, and vagina. COVID 19 could impact more on human reproduction and lead to a loss of fertility status for a while. All antiviral treatments could pose a negative impact on human reproduction. Further research should be carried out on the already existing theoretical hypothesis of SARS-Co-V-2 on human reproduction.