Coronavirus Can Infect the Ear, Study Suggests

The coronavirus that causes COVID-19 has been found inside the ear and a part of the head, according to a small study.

Researchers who performed autopsies on COVID-19 patients found SARS-CoV-2, the virus that causes the disease, in the middle ear and the mastoid area of the head. The mastoid is the hollow bone behind the ear, while the middle ear is an air-filled space containing three small bones that help us to hear. The findings were published in the journal JAMA Otolaryngology–Head & Neck Surgery.

The study involved three deceased people who tested positive for SARS-CoV-2 and had COVID-19: one woman in her 80s, and a man and woman both in their 60s. They died 48, 16, and 44 hours before their autopsies, respectively.

The team removed their mastoids and took specimens from their middle ears, testing them for the virus. Two patients tested positive for SARS-CoV-2 in the mastoid or middle ear. Of the six mastoids, two tested positive, as did three of the six middle ears.

Co-author Dr. C. Matthew Stewart, associate professor of head and neck surgery at the Johns Hopkins University School of Medicine, told Newsweek the team had to use tools and techniques dating back to the early 1900s as which surgeons usually use for such procedures—like hand-held drills—are not safe to use during the COVID-19 pandemic. That's because they release airborne droplets and particles.

Asked whether the virus had infected this part of the body or was present on the surface, Stewart said there is no conclusive answer for various reasons.

But as the lining of this part of the body is the same as the airways in the lung and the tissues of the sinuses, the authors think the tissue was actively infected.

Stewart said the team was surprised to find the virus in different areas and sides of the body in so few patients. They believe this indicates severely ill COVID-19 patients may have the virus in their ears.

Asked about the limitations of the research, Stewart said the study involved a small number of individuals, and was designed to explore the effect of COVID-19 so there wasn't a control group. Also, the longer it takes for an autopsy to occur, the less likely it is that the virus will be found in tissue.

Stewart hopes confirming the presence of the virus in this part of the body will help healthcare workers who work in this area stay safe.

The team now wants to understand the long-term effects, if any, of recovering from a SARS-CoV-2 infection on the ear and mastoid.

"We hypothesize that potential symptoms could be changes in the character and quality of hearing, balance, ringing, or sensations of fullness or pressure. There are also special sensory nerves that travel through this space. We now have reasons to include this type of evaluation in those patients who have recovered from COVID-19," he said.

Dr. Bradley W. Kesser of the University of Virginia Department of head and neck surgery said in a commentary published alongside the research that other members of the coronavirus family of germs have been previously found in human ears. But, until now, never SARS-CoV-2.

He wrote in JAMA Otolaryngology–Head & Neck Surgery: "By isolating SARS-CoV-2 from the middle ear and mastoid in postmortem ears and mastoid cavities in patients succumbing to COVID-19, the study by Frazier et al offers proof of principle of the virus' ability to access the middle ear and/or mastoid, documents another potential route of SARS-CoV-2 transmission, and addresses the implications for protection of health care workers caring for patients with ear disease."

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A stock image shows a woman's ear. Scientists believe SARS-CoV-2 can infect the ear.