Journal of Medical Council of Iran
Volume 43 - Series of Sessions on Post-Acute COVID-19 Syndrome
jmciri 2025, 43 - Series of Sessions on Post-Acute COVID-19 Syndrome: 16-25 |
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Zarezadeh Mehrabadi A, Mosaffa N, Hantoushzadeh S, Ghanbari Z, sadr M, soleimanifar N, et al . Immunopathological Effects of Long COVID on the Reproductive System. jmciri 2025; 43 (S1) :16-25
URL: http://jmciri.ir/article-1-3448-en.html
URL: http://jmciri.ir/article-1-3448-en.html
Ali Zarezadeh Mehrabadi 
, Nariman Mosaffa , Sedigheh Hantoushzadeh , Zinat Ghanbari , Maryam Sadr , Narjes Soleimanifar , Sara Assadiasl , Mohammadali Zolfaghari , Abdolrahman Rostamian , Alireza Esteghamati , Mohammad hossein Nicknam
, Nariman Mosaffa , Sedigheh Hantoushzadeh , Zinat Ghanbari , Maryam Sadr , Narjes Soleimanifar , Sara Assadiasl , Mohammadali Zolfaghari , Abdolrahman Rostamian , Alireza Esteghamati , Mohammad hossein Nicknam
Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran
Abstract: (77 Views)
Background: Due to thePost-Acute Sequelae of COVID-19 (PASC), commonly known as Long COVID, is a multisystemic condition characterized by persistent or newly developed symptoms following recovery from the acute phase of SARS-CoV-2 infection. Growing evidence suggests that the reproductive systems in both females and males are significant targets of this syndrome.
Results: The pathophysiology of Long COVID concerning the reproductive system is complex and multifactorial. It involves viral or antigenic persistence in gonadal tissues, chronic inflammation stemming from the initial cytokine storm, endothelial damage and microthrombosis due to processes such as NETosis, and the emergence of autoimmune phenomena. In women, the most common complications include menstrual irregularities (changes in bleeding volume and cyclicity), exacerbation of pelvic pain and endometriosis, and concerns about a potential decline in ovarian reserve (AMH). Iranian studies have reported a high incidence of these disorders. In men, damage to the blood-testis barrier, viral orchitis, and systemic inflammation have led to significant reductions in sperm concentration, motility, and morphology, as well as an increased sperm DNA Fragmentation Index (DFI). Furthermore, numerous cases of secondary hypogonadism have been documented.
Conclusion: Long COVID poses a serious threat to reproductive health. Its immunopathological complexities necessitate a meticulous approach to the clinical monitoring of patients, including hormonal and gonadal function assessments. In Iran, research priorities should be directed towards establishing a national registry, conducting prospective cohort studies, and investigating the genetic predispositions of the Iranian population to develop tailored, region-specific diagnostic and therapeutic protocols.
Results: The pathophysiology of Long COVID concerning the reproductive system is complex and multifactorial. It involves viral or antigenic persistence in gonadal tissues, chronic inflammation stemming from the initial cytokine storm, endothelial damage and microthrombosis due to processes such as NETosis, and the emergence of autoimmune phenomena. In women, the most common complications include menstrual irregularities (changes in bleeding volume and cyclicity), exacerbation of pelvic pain and endometriosis, and concerns about a potential decline in ovarian reserve (AMH). Iranian studies have reported a high incidence of these disorders. In men, damage to the blood-testis barrier, viral orchitis, and systemic inflammation have led to significant reductions in sperm concentration, motility, and morphology, as well as an increased sperm DNA Fragmentation Index (DFI). Furthermore, numerous cases of secondary hypogonadism have been documented.
Conclusion: Long COVID poses a serious threat to reproductive health. Its immunopathological complexities necessitate a meticulous approach to the clinical monitoring of patients, including hormonal and gonadal function assessments. In Iran, research priorities should be directed towards establishing a national registry, conducting prospective cohort studies, and investigating the genetic predispositions of the Iranian population to develop tailored, region-specific diagnostic and therapeutic protocols.
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