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Article

Evidence of SARS-CoV-2 Virus in the Middle Ear of Deceased COVID-19 Patients

by
Ionuț Isaia Jeican
1,2,
Maria Aluaș
3,*,
Mihaela Lazăr
4,
Lucian Barbu-Tudoran
5,6,
Dan Gheban
7,8,
Patricia Inișca
9,
Camelia Albu
7,10,
Septimiu Tripon
5,6,
Silviu Albu
1,*,
Costel Siserman
11,12,
Mihaela Laura Vica
12,13,
Monica Muntean
14,
Iulian Opincariu
2 and
Lia Monica Junie
15
1
Department of Head and Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
2
Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
3
Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
4
Viral Respiratory Infections Laboratory, Cantacuzino National Military-Medical Institute for Research and Development, 050096 Bucharest, Romania
5
Electron Microscopy Laboratory, Faculty of Biology and Geology, Babeș-Bolyai University, 400006 Cluj-Napoca, Romania
6
Electron Microscopy Integrated Laboratory, National Institute for R&D of Isotopic and Molecular Technologies, 400293 Cluj-Napoca, Romania
7
Department of Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
8
Department of Pathology, Emergency Clinical Hospital for Children, 400370 Cluj-Napoca, Romania
9
Department of Pathology, County Emergency Hospital, 330084 Deva, Romania
10
Imogen Medical Research Institute, County Clinical Emergency Hospital, 400014 Cluj-Napoca, Romania
11
Department of Legal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania
12
Institute of Legal Medicine, Department of Legal Medicine, ‘Iuliu Haţieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
13
Department of Cell and Molecular Biology, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
14
Department of Infectious Disease, Clinical Hospital of Infectious Disease, Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania
15
Department of Microbiology, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
 
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Authors to whom correspondence should be addressed.
Diagnostics 2021, 11(9), 1535; https://doi.org/10.3390/diagnostics11091535
Submission received: 22 July 2021 / Revised: 22 August 2021 / Accepted: 23 August 2021 / Published: 25 August 2021
(This article belongs to the Section Diagnostic Microbiology and Infectious Disease)
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Abstract

The presence of SARS-CoV-2 in the middle ear reveals the etiopathogenesis of otitis media in COVID-19, as well as an epidemiological risk during otologic examination and surgical procedures in COVID-19 patients. The study included 8 deceased patients with COVID-19. Tissue samples from the middle ear were subjected to virology, histopathology, scanning (SEM) and transmission (TEM) electron microscopy investigation. Ethmoidal mucosa samples were processed for virology analyses. qPCR resulted positive for 75% of nasal mucosa samples and 50% of middle ear samples. Ct values showed lower viral loads in middle ear samples. A proportion of 66.6% patients with positive results in the nasal mucosa showed positive results in the middle ear, and the subtype analysis of the complete genome sequences indicated B.1.1.7 lineage for all samples. In histopathological and SEM samples, no pathological aspects were identified. TEM revealed on the background of death critical alteration of cellular morphology, suggestive structures resembling SARS-CoV-2, goblet cells and immune cells. SARS-CoV-2 can be present in the middle ear of COVID-19 patients even if there is not clinical evidence of acute otitis media. Otolaryngologists could be particularly exposed to COVID-19 infection.
Keywords: SARS-CoV-2; COVID-19; middle ear; otologic surgery SARS-CoV-2; COVID-19; middle ear; otologic surgery

Share and Cite

MDPI and ACS Style

Jeican, I.I.; Aluaș, M.; Lazăr, M.; Barbu-Tudoran, L.; Gheban, D.; Inișca, P.; Albu, C.; Tripon, S.; Albu, S.; Siserman, C.; et al. Evidence of SARS-CoV-2 Virus in the Middle Ear of Deceased COVID-19 Patients. Diagnostics 2021, 11, 1535. https://doi.org/10.3390/diagnostics11091535

AMA Style

Jeican II, Aluaș M, Lazăr M, Barbu-Tudoran L, Gheban D, Inișca P, Albu C, Tripon S, Albu S, Siserman C, et al. Evidence of SARS-CoV-2 Virus in the Middle Ear of Deceased COVID-19 Patients. Diagnostics. 2021; 11(9):1535. https://doi.org/10.3390/diagnostics11091535

Chicago/Turabian Style

Jeican, Ionuț Isaia, Maria Aluaș, Mihaela Lazăr, Lucian Barbu-Tudoran, Dan Gheban, Patricia Inișca, Camelia Albu, Septimiu Tripon, Silviu Albu, Costel Siserman, and et al. 2021. "Evidence of SARS-CoV-2 Virus in the Middle Ear of Deceased COVID-19 Patients" Diagnostics 11, no. 9: 1535. https://doi.org/10.3390/diagnostics11091535

APA Style

Jeican, I. I., Aluaș, M., Lazăr, M., Barbu-Tudoran, L., Gheban, D., Inișca, P., Albu, C., Tripon, S., Albu, S., Siserman, C., Vica, M. L., Muntean, M., Opincariu, I., & Junie, L. M. (2021). Evidence of SARS-CoV-2 Virus in the Middle Ear of Deceased COVID-19 Patients. Diagnostics, 11(9), 1535. https://doi.org/10.3390/diagnostics11091535

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