In addition, testicular injury associated with SARS-CoV-2 infection may be an indirect consequence of exposure to systemic inflammation and/or SARS-CoV-2 antigens [28], and the concentration of leukocytes in the semen of patients with COVID-19 is increased, and the immune factors, including interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein-1 (MCP-1) is increased, which may affect spermatogenesis and interfere with fertility due to testicular immune response [29]. This evidence concerns the gene TNF and COVID-19.