Smoking and coronavirus: how does it affect

In reference to the various studies that have come out lately showing that nicotine may protect against COVID-19: does nicotine really protect against coronavirus?

No, neither nicotine nor tobacco has been shown to protect against both COVID-19 infection and its adverse effects.

In a study conducted in approximately 350 patients with COVID-19, the French found that fewer patients smoked than in the general population and this led them to hypothesize whether nicotine could protect and decrease the immune-inflammatory response of the most severe patients, although the Director General of Health in France himself did not recommend its use.

Along the same lines, it has been shown that infections by viruses of the coronavirus family are more frequent in smokers than in non-smokers.

In addition, when smoking, the gesture of repeatedly bringing the fingers to the mouth and nose is repeated, and this hand-to-face contact has been described as a frequent route of coronavirus infection. All this evidence suggests that cigarette smokers are at a higher risk of infection by the virus causing the current epidemic than non-smokers.

Why might nicotine be thought to have anti-inflammatory properties in Covid-19 patients?

It has been hypothesized that nicotine might compete with the coronavirus at nicotinic acetylcholine receptors and thus decrease the inflammatory response of the virus, but that is an unproven hypothesis at present.

It is really known that smoking worsens the course of respiratory diseases, can you give us an example, in the case of a person with pneumonia, how does smoking affect it?

Previous studies have shown that smokers are twice as likely as non-smokers to contract influenza and have more severe symptoms, while smokers were also observed to have a higher mortality in the previous MERS-CoV outbreak.

In pneumonias, it is estimated that altering the immune response favors the progression of pneumonia by releasing inflammatory mediators and its worse evolution.

Is it possible to conclude that smokers are more vulnerable to coronavirus infection?

A meta-analysis of 12 articles with a total of 9,025 patients studied showed that 17.8% of patients with a history of smoking had disease progression versus 9.3% of non-smoking patients. There was an association between smoking and progression of COVID-19, i.e. the presence of smoking habits doubled the probability of the disease progressing to severe forms relative to non-smokers. Smoking is detrimental to the immune system and its ability to respond to infections (including pneumonias).

The Spanish Society of Respiratory Pathology (SEPAR) reminds us:

• That nicotine is the drug that causes the addiction created by tobacco consumption.
• Smoking involves the introduction into the body, through the lungs, of “more than 4,000 toxic substances, including nicotine, oxidizing substances, tars, nitrosamines and carbon monoxide”.
• “There is no scientific data, neither reliable nor contrasted, to ensure that nicotine consumption contributes to reduce the probability of coronavirus infection”.
• Oxidizing substances are the main causes of pulmonary pathology associated with tobacco consumption: COPD, upper respiratory tract infections, pneumonia, etc.
• While tars and nitrosamines are responsible for tumor pathology associated with tobacco consumption: lung, oropharyngeal, laryngeal, esophageal, esophageal, pancreatic and bladder cancers, etc.
• Carbon monoxide is the main cause of cardiovascular pathology associated with tobacco consumption.