SARS-cov2 virus binds to ACE2 receptors and enter the cells to complete its replication cycle. This is considered as the main pathological mechanism of direct cell infection and damage by the virus. Therefore, cells with increased ACE2 expression are potential target of viral invasion. Among different body tissues, testis shows nearly the highest level of ACE2 mRNA and protein expression. At the level of testicular cells, four main cell types; seminiferous duct cells, spermatogonia, Leydig cells and Sertoli cells, show higher rate of ACE2 mRNA expression. If the virus causes damage to these cells, the process of spermatogenesis could be affected which might pose risk to male fertility.

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