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- Researchers found that people with acid reflux and Barrett’s esophagus were at an unusual risk of contracting the new coronavirus through food.
- People with Barrett’s esophagus develop intestinal cells in the esophagus after prolonged acid reflux. These cells have receptors that can bind to the coronavirus.
- However, there is no evidence that people with Barrett’s disease have higher rates of contracting COVID-19 or are at greater risk than anyone. But more research is needed to determine the real risk of infection in this category of patients.
More than a year has passed since the first infection with the novel coronavirus was confirmed, so most people should know how the virus is spread. Droplets and aerosols generated by coughing, sneezing, and talking can travel through the air and enter the upper respiratory tract of other people. The virus enters through the nose, mouth or eyes and begins to spread to local cells. Eventually, it reaches the lungs, where it does the most damage.
This is why face masks, social distancing, hand washing and good ventilation of indoor spaces are recommended. There is also a risk of infection by touching contaminated surfaces, although droplets and aerosols are the main factors of infection. But researchers at Washington University’s St.Louis School of Medicine speculate that some people may be at risk of infection in an unusual way – eating food.
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In the early days of the pandemic, we learned that food does not spread COVID-19. The virus binds to ACE2 receptors in the nose and lungs, but not in the digestive tract. Stomach acid can destroy particles that might be in food. Cooking food will also destroy the virus. Health experts still advised people to wash their hands often when handling food brought home before preparing meals or handling deliveries. In the months that followed, health authorities, including the WHO, further emphasized the idea that transmission through food packaging is unlikely.
Researchers in Saint-Louis have discovered something that does not apply to everyone who may be exposed to the virus. They have studied patients with a disease called Barrett’s esophagus and develop esophageal cells capable of binding to the new coronavirus.
Acid (or gastric) reflux can cause long-term damage to the esophagus, including changes in cells that start to look like cells in the gut. These cells are equipped with ACE2 receptors, so the virus could bind to them while passing through the esophagus.
“There is no evidence yet that people with Barrett’s esophagus have higher rates of COVID-19 or are at greater risk, but part of the reason is that this has not been studied. Dr. Jason C. Mills said in a statement. “Now that we’ve connected these dots, it may be helpful to look and see if people with Barrett have higher infection rates.”
People with Barrett’s esophagus regularly take a type of medicine called a proton pump inhibitor to suppress acidic secretions. As a result, the acidity of the stomach is reduced, which could have another side effect. More viruses can pass through the stomach and bind to receptors in the gut.
About one in five people in the United States suffers from gastric reflux, but that doesn’t mean they all are at risk of contracting the virus through food. Researchers have shown via lab experiments that the virus can bind to altered cells in the esophagus, but this is not proof that this actually happens in real life. It is also not known what would happen if a person with Barrett’s disease contracted the virus only from food, but not through the airways.
However, the researchers point out that if a person already has low levels of the virus in their airways, they might swallow secretions containing the virus, which would bind to abnormal cells in the lower part of the esophagus. It might make them sicker, but these are all speculations that need further research. What scientists have proven so far is that the virus can indeed bind to Barrett’s esophageal cells.
Many patients with COVID-19 develop gastrointestinal symptoms, including abdominal pain and diarrhea. But it is not known if Barrett could impact these symptoms or increase the severity of COVID-19.
“The concern would be that, especially for Barrett’s patients, there might even be a susceptibility to infection from foods containing viral particles,” Mills said. “This study provides data indicating that we need to take a closer look at whether a substantial part of the population is likely to be infected by what they swallow.”
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