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Smoking and COVID-19: Adding Fuel to the Flame.

ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic, an infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2), has led to more than 771,000 deaths worldwide. Tobacco smoking is a major known risk factor for severe illness and even death from many respiratory infections. The effects of smoking on COVID-19 are currently controversial. Here, we provide an overview of the current knowledge on the effects of smoking on the clinical manifestations, disease progression, inflammatory responses, immunopathogenesis, racial ethnic disparities, and incidence of COVID-19. This review also documents future directions of smoking related research in COVID-19. The current epidemiological finding suggests that active smoking is associated with an increased severity of disease and death in hospitalized COVID-19 patients. Smoking can upregulate the angiotensin-converting enzyme-2 (ACE-2) receptor utilized by SARS-CoV-2 to enter the host cell and activate a 'cytokine storm' which can lead to worsen outcomes in COVID-19 patients. This receptor can also act as a potential therapeutic target for COVID-19 and other infectious diseases. The COVID-19 pandemic sheds light on a legacy of inequalities regarding gender, racial, and ethnic health disparities associated with active smoking, thus, smoking cessation may help in improving outcomes. In addition, to flatten the COVID-19 curve, staying indoors, avoiding unnecessary social contact, and bolstering the immune defense system by maintaining a healthy diet/living are highly desirable.

SUBMITTER: Kashyap VK

PROVIDER: S-EPMC7555793 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Smoking and COVID-19: Adding Fuel to the Flame.

Kashyap Vivek K VK Dhasmana Anupam A Massey Andrew A Kotnala Sudhir S Zafar Nadeem N Jaggi Meena M Yallapu Murali M MM Chauhan Subhash C SC

International journal of molecular sciences 20200909 18

The coronavirus disease 2019 (COVID-19) pandemic, an infection caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2), has led to more than 771,000 deaths worldwide. Tobacco smoking is a major known risk factor for severe illness and even death from many respiratory infections. The effects of smoking on COVID-19 are currently controversial. Here, we provide an overview of the current knowledge on the effects of smoking on the clinical manifestations, disease progression, inflam ...[more]

PMID: 32916821

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Project description:INTRODUCTION:This ecological study investigates the association between smoking prevalence and COVID-19 occurrence and mortality in 38 European nations as of May 30, 2020. METHODS:Data were collected from Our World in Data. Regression analysis was conducted to adjust for potential confounding factors such as economic activity (gross domestic product), the rate of COVID-19 testing, and the stringency of COVID-19 control policies. RESULTS:There was a statistically significant negative association between smoking prevalence and the prevalence of COVID-19 across the 38 European nations after controlling for confounding factors (p = 0.001). A strong association was found between the prevalence of COVID-19 per million people and economic activity (p = 0.002) and the rate of COVID-19 testing (p = 0.0006). Nations with stricter policy enactment showed fewer COVID-19 cases per million people, but the association was not significant (p = 0.122). Delaying policy enactment was associated with a greater prevalence of COVID-19 (p = 0.0535). Evidence of a direct association between smoking prevalence and COVID-19 mortality was not found (p = 0.626). There was a strong positive association between COVID-19 mortality rate and the prevalence of COVID-19 cases (p < 0.0001) as well as the proportion of the population over 65 years of age (p = 0.0034) and a negative association with the rate of COVID-19 testing (p = 0.0023). CONCLUSIONS:We found a negative association between smoking prevalence and COVID-19 occurrence at the population level in 38 European countries. This association may not imply a true or causal relationship, and smoking is not advocated as a prevention or treatment of COVID-19. IMPLICATIONS:Given the evidence of this ecological study, and of several other studies that found an underrepresentation of smoking prevalence in hospitalized cases, it may be worth examining, in laboratory experiments and controlled human trials, if nicotine offers any protection against COVID-19. Most importantly, to date, no study, including this one, supports the view that smoking acts as a treatment intervention or prophylaxis to reduce the impact or ameliorate the negative health impacts of COVID-19.

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Smoking and COVID-19: Adding Fuel to the Flame.

Publications

Smoking and COVID-19: Adding Fuel to the Flame.

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