Smokers are more predisposed to Conona virus infection (COVID 19) and its complications

As of the 21st of March, 177 countries have witnessed more than 234,073 incident cases with 9,840 deaths. This ongoing “pandemic” has affected people across races and cultures in high-, middle- and low- income countries. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

A study published in the Chinese Medical Journal, undertaking research among patients affected by the Corona virus has found that those with a history of smoking were 14 times more likely to develop pneumonia than non-smokers. https://journals.lww.com/cmj/Abstract/publishahead/Analysis_of_factors_associated_with_disease.99363.aspx

Early evidence shows us that the ACE2 gene expression, which the novel corona virus uses to infect cells, is significantly higher in smokers than non-smokers, suggesting a higher susceptibility among smokers. https://www.preprints.org/manuscript/202002.0051/v1

A correspondence in Lancet shows a gender predilection toward males and trend towards smokers among the people with severe COVID-19.  https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30117-X/fulltext

Smoking is an established risk factor for many respiratory infections such as influenza. https://academic.oup.com/eurpub/article/28/1/150/4108100

Smoking causes a large amount of inflammatory changes leading to more mucous formation that makes it difficult to clear the lungs. This, along with the immune compromised state, leads to a greater risk of viral and bacterial infections. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582929/

Vaping specifically, has been shown to suppress the activity of immune and inflammatory response genes in nasal cells that are responsible of fighting against these bugs. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4967187/

The Center for Disease Control has issued a statement that young adults under age 44 years make up a large part of the COIVD-19 hospitalizations in the US and many scientists have begun questioning whether the vaping epidemic might have contribute to this. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm

A study in the New England Journal of Medicine has also shown that almost a third of the population affected in China had at least one coexisting illness such as chronic obstructive pulmonary disease.  The World Health Organization (WHO) has issued a statement saying that older people and persons with pre-existing medical conditions (such as high blood pressure, heath disease, lung disease, cancer or diabetes) appear to be more severely affected by Novel Corona virus than others. They also suggest that smoking does not kill the virus, and in fact is harmful to those infected.

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—20-march-2020

Scientists from around the world have issued comments suggesting that the Corona virus may impact those people who are long-term smokers and possibly vapers more seriously.

Published by Prof Pankaj Chaturvedi

Deputy Director, Center for Cancer Epidemiology, Tata Memorial Center, Mumbai. Professor, Department of Head Neck Surgery, Tata Memorial Hospital, Mumbai

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