TINJAUAN LITERATUR: DAMPAK PENYAKIT KORONAVIRUS (COVID-19) TERHADAP KESEHATAN REPRODUKSI PADA PRIA DAN WANITA

  • Nofri Zayani Dosen Keperawatan Sekolah Tinggi Ilmu Kesehatan Yatsi

Abstract

Pandemi COVID-19 yang disebabkan oleh sindrom pernapasan akut parah, coronavirus 2 (Sars-Cov-2) telah menjadi ancaman bagi dunia kesehatan, termasuk kesehatan tim. Ekspresi gen ACE2 dan TMPRSS2 sebagai reseptor yang memfasilitasi Sars-Cov-2 masuk ke dalam sel host ditemukan populer dalam organ testis, ovarium, endometrium uterus, dan plasenta. Penelitian ini bertujuan mengkaji potensi dampak COVID-19 terhadap kesehatan infeksi pada pria, wanita, wanita hamil, dan neonatus. Penelitian ini merupakan tinjauan pustaka dengan menelaah dan menganalisis berbagai sumber penelitian asli yang relevan tentang dampak COVID-19 terhadap kesehatan tim. Pencarian artikel dilakukan pada databaseelektronik PubMed , Google Scholar , dan Science Direct dengan kata kunci “Sars-Cov-2“, “COVID-19”, “kesehatan reproduksi wanita di bawah COVID-19”, “Sars-Cov-2 in gonad”, “Sars-Cov -2 pada testis ”,“ infeksi 2019-nCoV ”,   dan“ kesehatan reproduksi wanita hamil di bawah COVID-19 ” sejak bulan Juli sampai Agustus 2020. Penelaahan dan analisis lebih mendalam dilakukan hanya pada 15 artikel penelitian asli menggunakan metode penilaian kritis. Hasil studi menunjukkan bahwa infeksi COVID-19 pada pria secara langsung menurunkan tingkat hormon testosteron basal dan hipertermia testis sehingga mengakibatkan hormon FSH turun, LH meningkat, kerusakan sel-sel testis, ketidaknyamanan skrotum, dan disfungsi ereksi. Sementara itu, hasil RT-PCR pada biopsi jaringan testis dan cairan semen tidak ditemukan keberadaan RNA Sars-Cov-2. Sedangkan dampak infeksi COVID-19 pada wanita tidak hamil belum ada laporan. Pada wanita hamil, stres dan penurunan daya tahan tubuh akibat infeksi COVID-19 menyebabkan abortus pada trimester pertama sehingga beresiko terhadap kesehatan kelompok. Pemeriksaan plasenta RT-PCR, cairan ketuban, ASI, darah dan swabnasofaring neonatus menunjukkan negatif dari RNA Sars-Cov-2 yang tidak berada pada janin yang terjadi secara vertikal dari ibu ke janin. Neonatus umumnya lahir normal dan sehat baik melalui persalinan pervaginam maupun caesar. Tindakan waspada tetap perlu dilakukan oleh pria dan wanita untuk kemungkinan risiko jangka panjang infeksi Sars-Cov-2 terhadap kesehatan pers.

References

Al-Lami, A.; Urban, R. J.; Volpi, V.; Algburi, A. M. A. & Baillargeon, J. (2020). Sex hormones and novel corona virus infectious disease (COVID-19). Mayo Clinic Proceedings. 1-13. doi.org/10.1016/j.mayocp.2020.05.013.
Cao, D.; Yin, H.; Chen, J.; Tang, T.; Peng, P,; Li, R.; Xie, H.; Wei, X.; Zhao, Y.; & Sun, G. (2020). Clinical analysis of ten pregnant women with COVID-19 in Wuhan China: A retrospective study. International Journal of Infections Diseases. 95(20), 294-300. doi.org/10.1016/j.ijid.2020.04.047.
Castillo, I. H.; Leon, P. S.; Peiro, A. D.; Pelicer, A. & Gimeno, P. D. (2020). Sars-Cov-2 infection risk assessment in the endometrium: viral infection related gene expression across the menstrual cycle. Fertility and Sterility, 82(20), 238-245. doi.org/10.1016/j.fertnstert. 2020.06.026.
Doria, M.; Laranjo, C.; Peixinho, C.; Laranjo, M. & Varejao, A. M. (2020). Covid-19 during pregnancy: A case series from an universally tested population from the north of Portugal. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 30(19). 30-40. doi.org/10.1016/j.ejogrb.2020.05.029.
Durairajanayagam, D.; Sharms R. K.; Plessis, S. S.; Agarwal, A. (2014). Testicular heat stress and sperm quality. Male Fertility. 105-125. doi: 10.1007/978-1-4939-1040-3_8.
Isidori, M. A.; Buvat, J.; Corona, G.; Goldstein, I.; Jannini, A. E.; Salonia, A.; Traish, M. A. & Maggi, M. (2013). A critical analysis of the role of testosterone in erectile function: From pathophysiology to treatment. European Urology. 65(14). 99-112. doi.org/10.1016/j.eururo. 2013.08.048.
Joseph, D. N. & Whirledge, S. (2017). Stress and the HPA Axis: Balancing homeostasis and Fertility. International Journal of Molecular Sciences. 18(2224), 1-15.
Khalil, A.; Hill, R.; Ladhani, S.; Pattisson, K.; & O’Brien, P. (2020). Sars-Cov-2 in pregnancy: Symptomatic pregnant women are only the tip of the iceberg. American Journal of Obstetrics and Gynecology. 78(20), 1-6. oi.org/10.1016/ j.ajog.2020.05.005.
Li, Z.; Yin, T.; Fang, F.; Li Q.; Chen, J.; Wang, X.; Hao, Y.; Wu, X.; Duan, P.; Wang, Y.; Cheng, D.; Zhou, X.; Zafar, M. I.; Yang, J. & Qiao, J. (2020). Potential risks of Sars-Cov-2 infection on reproductive health. Reproductive BioMedicine Online. 00(00), 1-7. doi.org/10.1016/j.rbmo.2020.04.018 1472-6483.

Liva, S. M. & Voskuhl, R. R. (2001) Testosterone acts directly on CD4β T lymphocytes to increase IL-10 production. The Journal of Immunology. 1(167), 2060–2067. doi: 10.4049/jimmunol. 167.4.2060.
Lokken, E. M.; Walker, C. L.; Delaney, S.; Kachikis, A.; Kretzer, N. M.; Erickson, A.; Resnick, R.; Vanderhoen, J.; Hwang., J. K.; Kline, C. R. & Waldorf, K. A. (2020). Clinical characteristics of 46 pregnant women with a Sars-Cov-2 infection in Washington State. American Journal of Obstetrics and Gynecology. 78(20), 1-39. doi.org/10.1016/j.ajog.2020.05.031.
Ma, L.; Xie, W.; Li, D.; Shi1, L.; Mao, Y.; Xiong, Y.; Yuanzhen, Z. Y. Zhang, M. (2020). Effect of Sars-Cov-2 infection upon male gonadal function: A single center-based study. Fertility and sterility. 30(20), 1-14. doi.org/10.1101/ 2020.03.21.20037267.
Manau, Y. B. I. A & Guimera A. B. M. (2020). Pandemia del Sars-Cov-2 y reproduccion asistida. Clinica e Investigacion en Ginecologia y Obstetricia. 3(20). 1-17. doi.org/10.1016/ j.gine.2020.06.004.
Mohamad, N. V.; Wong, S. K.; Hasan, W. N. W.; Jolyy J. J.; Farhana, M. F. N.; Nirwana, S. I. & Chin K. Y. (2018). The relationship between circulating testosterone and inflammatory cytokines in men. The Aging Male. 14(73), 1-13. doi.org/10.1080/13685538.2018.1482487.
Mulveya, J.; Magrob, C. M.; Mab, L. X.; Nuovoc, G.; J. & Baergen, R. N. (2020). Analysis of complement deposition and viral RNA in placentas of COVID-19 patients. Annals of Diagnostic Pathology. 46(20), 151-155. doi.org/10.1016/j.anndiagpath.020.151530.
Nora, H.; Philippos, E.; Marcel, E.; Cornelius, D.; Dunja, B. B.; Ortwin, A.; Steffen, K. J.; & Petra, B. A. (2020). Assessment of Sars-Cov-2 in human semen - a cohort study. Fertility and Sterility. 82(20), 1-14. doi.org/10.1016/ j.fertnstert.2020.05.028.
Pan, F.; Xiao, X.; Guo, J.; Song, Y.; Li, H.; Patel H. P.; Spivak, A. M.; Xiong, C.; Li, P. S. & Hotaling, J. M. (2020). No evidence of severe acute respiratory syndrome coronavirus 2 in semen of males recovering from coronavirus disease 2019. Fertility and sterility. 113(6), 135-1140. doi.org/10.1016/j.fertnstert.2020.04.024.
Parker, V. J.; Alison J. & Douglas, A. J. (2010). Stress in early pregnancy: Maternal neuroendocrine immune responses and effects. Journal of Reproductive Immunology. 85(20), 86-92. doi:10.1016/j.jri.2009.10.011.
Qiancheng, X.; Jian, S.; Lingling, P.; Lei, H.; Xiaogan, J.; Weihua, L.; Gang, L.; Shirong, L.; Zhen, W.; GuoPing, Z. & Lei, Z. (2020). Coronavirus disease 2019 in pregnany. International Journal of Infectious Diseases. 95(20), 376-383. doi.org/10.1016/j.ijid.2020.04.065.
Rastrelli, G.; Stasi V. S.; Inglese, F.; Beccaria, M.; Garuti, M.; Costanzo, D. D.; Spreafico, F.; Greco G. F.; Cervi, G.; Maggi, M.; Donno, G. D. & Vignozzi, L. (2020). Low testosterone level predict clinical adverse outcome in Sars-Cov-2 pneumonia patients. Andrology. 1-17. doi:10.1111/ANDR.12821
Salam, A. P. & Horby, P. W. (2017). The breadth of viruses in human semen. Emerging Infectious Diseases. 23(11), 1922-1925. doi.org/10.320/eid2311.171049.
Segars, J.; Katler, Q.; McQueen,; D. B.; Kotlyar, A.; Glenn, T.; Knight, Z.; Feinberg, E. C.; Taylor, H. S.; Toner, J. P. & Kawwass, J. F. (2020). Prior and novel coronaviruses, coronavirus disease 2019 (COVID-19), and human reproduction: What is known? Fertility and Sterility. 13(16), 1140-1150. doi.org/10.1016/j.fertnstert.2020.04.025.
Song, C.; Wang, Y.; Li, W.; Hu, B.; Chen, G.; Xia, P.; Wang W.; Li, C.; Hu, Z.; Yang X.; Yao, B. & Liu, Y. (2020). Detection of 2019 novel coronavirus in semen and testicular biopsy specimen of COVID-19 patients. Fertility and Sterility. 4(20), 1-14. doi.org/10.1101/2020.03.31.2004233.
Suzuki, A. (2020). Psychological status during the first trimester of pregnancy under the COVID-19 epidemic in Japan. The Journal of Maternal- Fetal & Neonatal Medicine. 0(0), 1-4. doi.org/10.1080/14767058.2020.1793319.
Stanley, K. E.; Thomas, E.; Leaver, M.; Wells, D. (2020). Coronavirus disease (COVID-19) and fertility: Viral host entry protein expression in male and female reproductive tissues. Fertility and Sterility. 82(20). 1-21. oi.org/10.1016/j.fertnstert. 2020.05.001.
Varga, Z.; Flammer, A. J.; Steiger, P.; Haberecker, M.; Andermatt, R.; Zinkernagel, A. S.; Mehra, M. R.; Schuepbach, R. A (2020). Endothelial cell infection and endotheliitis in COVID-19. . Lancet. 0(0) 1-3. doi.org/10/1016/s0140-6736(20)30937-5.
Williams, R. A. M. Burd, J.; Felder, L.; Khoury R.; Berstein, P. S.; Avila, K.; Penfield C. A.; Roman, A. S.; DeBolt, C. A.; Anderso, K. & Berghella, V. (2020). Clinical course of severe and critical COVID-19 in hospitalized pregnancies: A US cohort study. American Journal of Obstetrics & Gynecology. 33(20), 1-9.doi.org/10.1016/j.ajogmf.2020.1001 34.
Wang, L.; Li, G.; Xin, C.; Wang, Y.; & Yang, S. (2020). Changes in sexual behaviors of young women and men during the coronavirus disease 2019 outbreak: A convenience sample from the epidemic area. Journal Sex Medicine. 20(20), 1-4. doi.org/10.1016/j.jsxm. 2020. 04.380.
Yan, J.; Guo, J.; Fan, C.; Juan, J., Yu, X., Li, J.; Feng, L.; Li, X.; Chen, H.; Qiao, Y.; Lei, L.; Wang, C.; Xiong, G.; Xiao, F.; He, W.; Liona C.; Poon, H. & Yang, H. (2020). Coronavirus disease 2019 in pregnant women: areport based on 116 cases. American Journal of Obstetrics & Gynecology. 10(2020), 1-14. doi.org/ 10.1016/j.ajog.2020.04.014.
Yang, M.; Chen, S.; Huang, B.; Zhong, M. J.; Su, H.; Chen, J. Y.; Cao, Q.; Ma, L.; He, J.; Li, X. F.; Li, X.; Zhou, J. J.; Fan, J.; Luo, D. J.; Chang, N. X.; Arku, K.; Zhou, M.; & Nie, X. (2020). Pathological findings in the testes of COVID-19 patients: Clinical implications. European Urology. 30(20), 1-6. doi.org/10.1016/j.euf.2020.05.009.
Yaniilton, T. S.; Tulac, V. K. C. & Dosiou, C. (2006). Molecular phenotyping of human endometrium distinguishes menstrual cycle phases and underlying biological processes in normo-ovulatory women. Fertility and Sterility. 147 (06), 1097–121.
Published
2021-04-30