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

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

URL: 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:Evidence resource
Drug Type:Tobacco
Intervention Type:AOD disorder harm reduction
Date:24 March 2020
Subjects:B Substances > Tobacco (cigarette smoking)
G Health and disease > Disorder by cause > Communicable disease > Viral disease

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