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\begin{document}

\title{An ecological comparison study on the effect of the COVID-19 pandemic on
semen quality based on a nationwide loosening of COVID-19 curbs in China
at the end of 2022}



\author[1]{Guang-hui Zhang}%
\author[2]{Jingchao Ren}%
\author[3]{Tingting Zhang}%
\author[4]{Ke Feng}%
\author[3]{Shengnan Zhang}%
\author[4]{Yanqing Xia}%
\author[1]{Heng Lu}%
\author[5]{Mingming Liu}%
\author[4]{Haibin Guo}%
\author[1]{Jia Cao}%
\affil[1]{Army Medical University}%
\affil[2]{Chongqing Medical University}%
\affil[3]{Zhengzhou University}%
\affil[4]{Henan Provincial People's Hospital}%
\affil[5]{PLA Northern Theater Command Center for Disease Control and Prevention}%


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  \date{May 22, 2024}


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\begin{abstract}
Although reports have shown an association between coronavirus disease
2019 (COVID-19) and a reduction in male semen parameters, no population
big-data analyses have been verified. This ecological comparative study
aimed to explore the effects of the COVID-19 pandemic on semen quality.
This ecological comparison study was based on the nationwide loosening
of COVID-19 curbs in China on 2022-12-07, 1 month after which, an 89\%
infection rate was reported in Henan Province, China. We compared semen
quality and serum hormone levels from 2023-01-07 to 4-30 and 2022-01-07
to 4-30 at the Reproductive Center of Henan Provincial People's
Hospital. Our results indicated a significant decrease in semen volume (
\emph{P}\textless{}0.0001), sperm concentration ( \emph{P}=0.0004),
total sperm count ( \emph{P}\textless{}0.0001), progressive motility (
\emph{P}\textless{}0.0001), and nonprogressive motility (
\emph{P}\textless{}0.0001) after the nationwide loosening of COVID-19
curbs. The effects on semen volume and total sperm count lasted for a
long time. An increase in the rate of sperm neck defects was observed (
\emph{P}\textless{}0.0001). Infection also caused hormone disruption in
prolactin ( \emph{P}\textless{}0.0001), testosterone ( \emph{P}=0.0220),
sex hormone-binding globulin ( \emph{P}\textless{}0.0001), and free
testosterone index ( \emph{P}=0.0126), and an increase in estrogen (
\emph{P}\textless{}0.0001), osteocalcin ( \emph{P}\textless{}0.0001),
and 25-OH-VD ( \emph{P}\textless{}0.0001). The present study revealed
that mild COVID-19 appeared to have a detrimental effect on semen
parameters.%
\end{abstract}%



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