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This is a surprising result. Smokers are far LESS likely to be hospitalized with COVID-19 that non-smokers and it looks robust across countries.
Why might this be? https://twitter.com/KlausKblog/status/1249048902495592450">https://twitter.com/KlausKblo...
Why might this be? https://twitter.com/KlausKblog/status/1249048902495592450">https://twitter.com/KlausKblo...
The US data from CDC is... well shocking. Almost literally unbelievable.
Only 1.3% of U.S. COVID-19 cases are current smokers. Only 2.3% are former smokers.
Possible explanation? Nicotine lowers ACE2 expression. (SARS-CoV-2 uses ACE2 for entry into target cells.)
https://ncbi.nlm.nih.gov/pmc/articles/PMC6295500/">https://ncbi.nlm.nih.gov/pmc/artic...
https://ncbi.nlm.nih.gov/pmc/articles/PMC6295500/">https://ncbi.nlm.nih.gov/pmc/artic...
One major New York hospital system that has released its data has a lot more smoking than the CDC data, but notably they have the odds ratio for tobacco use at less than 1. https://twitter.com/leorahorwitzmd/status/1249319859378405377">https://twitter.com/leorahorw...
Contra the theory above, a study from China finds higher ACE2 expression in smokers. https://www.medrxiv.org/content/10.1101/2020.03.18.20038455v1">https://www.medrxiv.org/content/1...
Question for the biochemists... *if* (big if!) there is a nicotine protective effect, is there an analog or derivative that could produce the same effect without the harms of nicotine?
Another more complex theory of the potential mechanism, this one more consistent with the recent study in China. https://twitter.com/TrevorSutcliffe/status/1249767401899454470">https://twitter.com/TrevorSut...
Several respondents have pointed me to this paper coauthored by Dr. Raymond Niaura, Interim Chair of the Department of Epidemiology at NYU.
https://www.qeios.com/read/article/561">https://www.qeios.com/read/arti...
https://www.qeios.com/read/article/561">https://www.qeios.com/read/arti...
Should note this disclaimer on the U.S. data from CDC. Let& #39;s see what the next update looks like.
There& #39;s a preprint on that French hospital data now. https://twitter.com/KlausKblog/status/1252418954435256326">https://twitter.com/KlausKblo...
Another French pre-print outlining a potential mechanism for a nicotine protective effect. https://www.qeios.com/read/article/581">https://www.qeios.com/read/arti...
The theory of a nicotine protective effect is going to be tested in French hospitals using nicotine patches on health workers and patients. https://www.theguardian.com/world/2020/apr/22/french-study-suggests-smokers-at-lower-risk-of-getting-coronavirus?CMP=share_btn_tw">https://www.theguardian.com/world/202...
More U.S. data.
Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54-75 Years
"Smoking, COPD, and alcohol use disorder were associated with a LOWER probability of a positive test."
https://www.medrxiv.org/content/10.1101/2020.04.09.20059964v1.full.pdf">https://www.medrxiv.org/content/1...
Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54-75 Years
"Smoking, COPD, and alcohol use disorder were associated with a LOWER probability of a positive test."
https://www.medrxiv.org/content/10.1101/2020.04.09.20059964v1.full.pdf">https://www.medrxiv.org/content/1...
The French high school study:
Smokers had a lower IAR compared to non-smokers (7.2% versus 28.0%, P <0.001). https://www.medrxiv.org/content/10.1101/2020.04.18.20071134v1">https://www.medrxiv.org/content/1...
Smokers had a lower IAR compared to non-smokers (7.2% versus 28.0%, P <0.001). https://www.medrxiv.org/content/10.1101/2020.04.18.20071134v1">https://www.medrxiv.org/content/1...
