Home > Covid-19 and smoking: the elephant in the room?

[Tobacco Control Blog] , Barnsley, Kathryn and Singh Sohal, Sukhwinder Covid-19 and smoking: the elephant in the room? (24 Mar 2020)

External website: https://blogs.bmj.com/tc/2020/03/24/covid-19-and-s...

The role of smoking in the contraction, transmission and mortality rate of Covid-19 should be given research attention, and countries should allocate resources to health stimulus packages, scientific research, and actions to further reduce smoking rates. New research shows smoking has the potential to upregulate angiotensin-converting enzyme-2 (ACE2) receptor, which has been proved to be the receptor for both the SARS-coronavirus (SARS-CoV) and the human respiratory coronavirus NL638.

Liu et al found progression of Covid-19 was more likely to occur in smokers, and smokers were 14 times more likely than nonsmokers to progress to pneumonia. Reporting on Covid-19 hospitalized patients in China, Liu et al say:  “This study suggested that the progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group.”

Cai recently reported higher ACE2 gene expression in smoker samples compared to never smokers. ACE2 is specifically expressed in a subset of type-2 alveolar cells (AT2), in which genes regulating viral reproduction and transmission are highly expressed. Smokers are therefore more susceptible to Covid-19 and smoking history should be considered in identifying the susceptible population and standardizing treatment regimens.

Item Type
Publication Type
International, Open Access, Web Resource
Drug Type
Tobacco / Nicotine
Intervention Type
Harm reduction
24 March 2020

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