Up until this point, scientists and health experts alike have reassured the public that it’s highly unlikely to contract the virus that causes COVID-19 through food or beverages. Now, research suggests that some people may have a higher risk of becoming infected with the novel coronavirus after swallowing something that’s contaminated.
A new study set to debut in the journal Gastroenterology this spring suggests that people with a common disorder called Barrett’s esophagus, which is a complication of gastroesophageal reflux disease (GERD), could potentially contract the virus through food. (Related: The One Vitamin Doctors Are Urging Everyone to Take Right Now.)
“There is no evidence yet that people with Barrett’s esophagus have higher rates of COVID-19 or are at any greater risk, but part of the reason is because that hasn’t been studied,” Jason C. Mills, MD, PhD of the Washington University School of Medicine in St. Louis and the senior investigator of the study, said in a statement. “Now that we’ve connected these dots, it may be worthwhile to look and see whether people with Barrett’s have higher rates of infection.”
In some people, the development of Barrett’s esophagus may precede adenocarcinoma, which is a type of cancer that forms in the lower esophagus. In recent years, rates of adenocarcinoma have increased, especially in white males, according to the Oregon Clinic.
How could someone with Barrett’s esophagus contract the novel coronavirus through food?
In a healthy person, it’s believed that even if food and drink were to contain viral particles of SARS-CoV-2 (the virus that causes the infectious disease COVID-19), stomach acid would quickly neutralize them. However, individuals who have gastric reflux may suffer from long-term damage to the esophagus, as stomach acid routinely backs up into it. About one in five people have reflux disease, which causes symptoms such as heartburn.
Over time, as well as in some people with GERD, cells in the esophagus can change and begin to resemble intestinal cells. Here’s where the gateway to infection may come into play: Intestinal cells have receptors that are capable of binding to the novel coronavirus, which led the researchers to believe that the cells lining the esophagus in those with Barrett’s could also develop these receptors.
By then eating or drinking something that was contaminated with active, viral particles, the receptors could, in theory, bind to the virus and infect the person.
“You can imagine that if someone already has low levels of the virus in their respiratory tract, that individual could swallow some respiratory secretions, and the virus could infect cells in the esophagus to make them sicker that way,” Ramon U. Jin, MD, PhD, the paper’s co-first author and a clinical fellow in the Division of Medical Oncology who studies Barrett’s esophagus, said in a press release.
What did this study reveal?
The researchers analyzed tissue from 30 patients with Barrett’s esophagus. What did they find? Each tissue sample had receptors for the SARS-CoV-2 virus, something which normal esophagus cells lack.
The scientists then built mini esophagus organs using these tissue samples and others in dishes, with cells sourced from both healthy people and those with Barrett’s esophagus. Sure enough, the virus was able to bind to those receptors and infect the mini organs made from the tissue and cells of someone with the condition.
How did the connection between Barrett’s esophagus and COVID-19 come about?
Jeffrey Wade Brown, MD, PhD—an instructor in medicine at the Division of Gastroenterology, and the other co-first author of the study—explains that he and his colleagues in the Mills Lab at the Washington University School of Medicine study how cells’ identity changes after injury. These changes are often referred to as metaplasia among the scientific community, and they also tend to signify precursors to cancer.
Other researchers at the university had already found that intestinal cells isolated in a dish were susceptible to infection with SARS-CoV-2. This prompted Brown and his colleagues to wonder if the intestinal cells (which resulted from metaplasia) in those with Barrett’s esophagus would then cause these patients to be more susceptible to infection.
“The biggest takeaway from our work is that we have potentially identified people, those with Barrett’s esophagus, who might be more susceptible to infection by SARS-CoV-2, because they might be affected by swallowing virus—not just breathing it in,” Brown tells Eat This, Not That!
“Future studies using data from large patient populations will be needed to confirm our suspicion that patients with Barrett’s esophagus are at higher risk of either developing the disease or have a more severe form of disease than the general population.”
For more, be sure to check out This Unexpected Vitamin May Help Weaken COVID Symptoms.
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