Immunohistochemical and qPCR Detection of SARS-CoV-2 in the Human Middle Ear Versus the Nasal Cavity: Case Series

Head Neck Pathol. 2022 Jun;16(2):607-611. doi: 10.1007/s12105-021-01378-6. Epub 2021 Aug 28.

Abstract

Viral infections have already been implicated with otitis media and sudden sensorineural hearing loss. However, the pathophysiology of COVID-19 as it relates to otologic disorders is not well-defined. With the spread of SARS-CoV-2, it is important to evaluate its colonization of middle ear mucosa. Middle ear and nasal tissue samples for quantitative RT-PCR and histologic evaluations were obtained from post-mortem COVID-19 patients and non-diseased control patients. Here we present evidence that SARS-CoV-2 colonizes the middle ear epithelium and co-localizes with the primary viral receptor, angiotensin-converting enzyme 2 (ACE2). Both middle ear and nasal epithelial cells show relatively high expression of ACE2, required for SARS-CoV-2 entry. The epithelial cell adhesion molecule (EpCAM) was use as a biomarker of epithelia. Furthermore, we found that the viral load in the middle ear is lower than that present in the nasal cavity.

Keywords: COVID-19; Coronavirus; Immunohistochemistry; Middle ear; Nasal cavity; SARS-CoV-2; qPCR.

MeSH terms

  • Angiotensin-Converting Enzyme 2
  • COVID-19* / diagnosis
  • Ear, Middle* / virology
  • Humans
  • Nasal Cavity* / virology
  • SARS-CoV-2* / isolation & purification

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2