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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/articles/PMC6295500/
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
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
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
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/article/561
Should note this disclaimer on the U.S. data from CDC. Let's see what the next update looks like.
