Figure 2

Ciliated epithelium from the BALF of intubated COVID-19 patient. (a) Mild infection (non-ARDS) HCQ⁻ group (b) Severe infection (ARDS) HCQ⁻ and (c) Severe infection (ARDS) with prophylactic HCQ⁺ group. Ciliated epithelium of each group of patients was imaged using the PAP test for identification of various cells in BALF (PAP), Immunofluorescence (merged image of DIC, DAPI, and Alexa flor 598) imaging using SARS-CoV-2 virus S protein-specific antibody for the determination of the level of infection through Fiji software (IF), Scanning electron microscopy for surface imaging of virus and to visualize the cellular morphology (SEM), and cellular ultrastructural details using transmission electron microscopy (TEM). The level of infections was highest in patient group B, followed by groups A and C. The cilia were mostly intact in each group of patients. SARS-CoV-2-like virus particles were seen on the surface and in the cell membrane (arrows). The ultrastructural damage was more prominent in patient group b, followed by groups c and a. N Nucleus, C Cilia, M Mitochondria, arrows SARS-CoV-2 virus.