Is nicotine an advantage or a disadvantage in case of contagion with the coronavirus?
Tobacco use kills about eight million people a year, so the French study published last week that smokers are less likely to get the coronavirus left many speechless.
In the preliminary study, conducted by the Pitié-Salpêtrière Hospital in Paris, it is stated that “smoking status appears to be a protective factor against SARS-CoV-2 infection” and that “nicotine may be suggested as possible preventive agent against infection by COVID-19 “, based on scientific literature and observations of the hospital itself.
Renowned neurologist Jean-Pierre Changeux hypothesizes that nicotine uses the same ACE2 receptors that SARS-CoV-2 uses to enter cells, and would prevent the spread of the new coronavirus.
Doctors at the Parisian hospital believe that the coronavirus could be infecting neurons in the office system and / or through the lungs, causing different symptoms, in contrast to the commonly accepted hypothesis that ACE2 receptors are the main route of entry for the new virus. in the cells.
Furthermore, nicotine would prevent the “cytokine storm” the uncontrolled reaction of the immune system that is causing the most serious cases and the majority of deaths.
A Chinese study also concluded that in a sample of 1,000 infected people only 12.6% were smokers, while the proportion of infections among the general population was 28%.
A clinical trial with nicotine patches is planned to investigate this theory. It will be tested as a prevention method for healthcare personnel, hospitalized patients and people in intensive care.
The study warns that “nicotine is a drug of abuse responsible for cigarette addiction” and adds that “smoking has serious pathological consequences and remains a serious health hazard”.
The general director of Health Jerome Salomon warns that “you have to be very careful. We must not forget the harmful effects of nicotine… what is proven is that smokers suffer severe cases of Covid,” he continued, advising not going back to smoking former smokers and remembering that “tobacco is the number one killer in France with 75,000 deaths a year”.
He warned that “non-smokers should not resort to nicotine substitutes at all,” which cause side effects, primarily heart, and addiction.
Despite the warnings, the new information has created confusion about the relationship between smoking and COVID-19, the disease caused by the new coronavirus.
So what do world health experts say? Are smokers less likely to contract the virus?
No. According to the World Health Organization (WHO), smokers are more vulnerable to infection.
“The act of smoking means that the fingers (and possibly the contaminated cigarettes) are in contact with the lips, which increases the possibility of transmission of the virus from the hand to the mouth,” the WHO said.
“Smoking products, such as hookahs, often involve sharing nozzles and hoses, which could facilitate transmission of COVID-19 in community and social settings.”
“Smokers may also have previous lung disease or reduced lung capacity, which would greatly increase the risk of serious manifestations.”
They recall that tobacco and other conditions that increase the need for oxygen or reduce the body’s ability to use it efficiently “will put patients at increased risk for serious lung diseases such as pneumonia.
Studies also show that smokers were more likely to die than non-smokers during the 2012 Middle East Respiratory Syndrome (MERS) outbreak.
In another statement to Euronews, the World Health Organization says they are currently reviewing research and studies on smoking and nicotine.
“Current evidence suggests that the severity of COVID is higher among smokers.”
“The only people who should be using nicotine patches right now are those who need to use them to quit smoking.”
In a report published in March by the European Center for Disease Control (ECDC), smokers have also been identified as a “vulnerable group” to COVID-19 infection.
The ECDC ensures that a higher expression of the ACE2 gene (angiotensin II converting enzyme) in lung tissues, something that increases with tobacco consumption, may be related to a “greater susceptibility” to the coronavirus, contrary to what the French study.
Although the available data may be limited, the scientific studies cited by the WHO and the ECDC state that smoking can make people more susceptible to serious complications of a coronavirus infection.
National authorities across Europe also adhere to the recommendations of the World Health Organization.
A foundation linked to the UK National Health System has released information about the coronavirus that there is “an increased risk for people who smoke.”
“If you are going to quit smoking, this is a very good time to do it,” said Medical Director Prof. Chris Whitty.
NHS guidelines also state that smoking increases the risk of “more than 50 serious illnesses.”
The French Ministry of Health in its information on the epidemic says that smokers are no more at risk of contamination, but they are “more at risk of developing serious diseases” and that smoking damages lung tissues and makes them more vulnerable to COVID-19.
In the midst of the commotion caused by the study, France has severely restricted the sale of tobacco substitute products.
Pharmacies can only sell up to a month’s supply of any nicotine product intended to curb dependence on cigarettes.
Selling products online has been completely banned.
The Ministry of Health said the measures were taken to “prevent the health risk related to excessive consumption or misuse” of nicotine products by people who hope to protect themselves from COVID-19.
Nicotine as protection?
The French study assumes that nicotine may protect against the coronavirus. It is based on the hypothesis “that nicotine binds to the cellular receptors (ACE2) used by the virus, thus preventing it from binding,” Changeux explains.
According to the researchers’ conclusion, the virus cannot enter the cell and cannot spread in the body. The La Pitié Salpêtrière hospital in Paris will investigate this result in more detail.
What role do ACE2 receptors really play?
However, there is no consensus among researchers that ACE2 receptors have a blocking effect. Neurologists James L. Olds and Nadine Kabbani of Fairfax, Virginia, had already published a study in The FEBS Journal on March 18. In this they assume that nicotine tends to stimulate cell receptors.
In doing so, they assume that viruses have an even better chance of penetrating cells. Something that could explain the especially severe development of the disease in smokers.
Smoking is not a solution
Only deeper investigations will be able to show whether French or American researchers are right. However, almost all doctors agree that smoking tobacco carries an additional risk of contracting COVID-19. And they advise that you quit smoking as soon as possible, because the coronavirus mainly attacks the lungs, which smokers have previously damaged.
Unlike taking pure nicotine, for example, through nicotine patches such as those used by people who want to quit smoking, smoking additionally loads the body with many harmful substances, including those that promote cancer.
Many studies and tests with nicotine patches of different doses are still needed. If the French study turns out to be correct, nicotine might even protect people who are exposed to patients with coronavirus and therefore exposed to an increased risk of infection.
However, taking nicotine is not safe, because it is a toxic substance. When smoking a cigarette, the smoker absorbs one to three milligrams of nicotine. And a cigarette contains approximately 12 milligrams of nicotine.
In the past, scientists studied the possibility that nicotine may also have positive effects on the body. For example, the effect of nicotine-like substances in the treatment of Parkinson’s and Alzheimer’s was examined. For people with serious illnesses like dementia, the nicotine test was favorable. But the result of this study, so far, does not mean that everyone has to start smoking.