Why are smokers less often hospitalized for coronaviruses?

Chinese smoke. More than half of the people are smokers and the World Health Organization (WHO) One third of the planet’s cigarettes Smoking in China But earlier this year Constantinos Farsalinos found something strange. Most of the people hospitalized for coronaviruses in the country did not seem to be smokers.

Farsalinos, a Greek cardiologist and tobacco mitigation expert, says that nicotine, a chemical found in tobacco, does not prevent COVID-19 or stop the worsening of symptoms. I’m thinking.

Although no conclusions can be drawn yet, the general hypothesis of Farsalinos is that nicotine has certain anti-inflammatory effects. The most serious COVID-19 symptom is known as an overreaction of the body’s immune system. “Cytokine Storm” During that storm, the immune system targets infections such as the lungs, which can become inflamed and lead to respiratory distress. The reason for Farsalinos, nicotine, may at least reduce its strength.

On the surface, it’s a strange theory. Smoking still The leading cause of preventable death in the worldIndeed, no one insists on developing habits as a precautionary measure. Nicotine is just one of many unusual solutions that are in the early stages of scientific investigation. Scientists seem to throw anything on the wall, estrogen, Think Over-the-counter heartburn medication, And test Immune system regulator Everything is aimed at treating cancer in the hope of finding a way to control the virus or the body’s response to the virus. (Everyone isn’t thinking of having someone Drink bleach. )

Observation of Farsalinos, Available in preprint And will be published in the journal soon Internal medicine emergency, Attracted the attention of scientists, policy makers, and tobacco control experts around the world. Some believe that this counter-intuitive information is important enough to pursue: it’s too early to tell, but the role of nicotine may need to be carefully reviewed, especially familiar Given the situation without.

“Everyone knows that smoking is obviously bad for you,” said Raymond Niura, a provisional chair of the New York University School of Epidemiology and a specialist in tobacco dependence and treatment. “Naturally, smokers will be much worse. I think so too, but I was surprised: that’s not what we’re seeing.”

Niaura is a co-author of Farsalinos and Greek public health scholar Anastasia Barbouni. Internal medicine emergency paper. It will be released soon and will be the first peer-reviewed paper on the subject. (Farsalinos told VICE that his other papers with similar more drastic conclusions will soon be available in other journals. Toxicology report. )

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The theory is not completely out of the left. Nicotine, a stimulant found in tobacco (and other plants like tomato, but in much smaller quantities), has already been studied for its neuroprotective properties and is of interest to scientists studying. Parkinson’s disease and Alzheimer’s disease. It is the chemicals from the burning of tobacco that cause heart attacks, cancer, and lung disease, Niaura said.

“As a policymaker, if you are really wrong, you should ask what consequences of acting as this is right.” “The disadvantages seem negligible to trying to understand them. There are ways to move forward.”

The French group of researchers, led by neuroscientist Jean-Pierre Change, does just that —Wants to test a nicotine patch Health care workers and patients who test positive for coronavirus. The team, which is based in the famous Pitiers Salpetriere in Paris, Observed Similar data in the French population by Farsalinos about the Chinese: Of the 343 inpatients, only 4.4% were recorded as smokers. Of the 139 outpatients, only 5.3% were recorded as smokers. This compares to a population in which more than a quarter of the French population smokes.

the study Caused such agitation In France last week, the government’s suspension of online sales of nicotine patches and other smoking cessation tools seemed to scare citizens from buying too much to treat themselves.

Unlike the study by Farsalinos, the French study has not yet undergone a peer-review process. These researchers also follow a similar theory, albeit with different hypotheses, but nicotine may prevent coronaviruses from invading cells in the body, quenching the storm of these cytokines. There is also a possibility. (Farsalinos hypothesis Internal medicine emergency The paper is centered around the so-called angiotensin converting enzyme 2, or ACE2. Receptors commonly thought to be latched by coronaviruses to enter human cellsThe French are Think it’s a virus It may enter the body through the nicotinic acetylcholine receptor, or nAChR (a receptor that is different in the lung and olfactory system). )

Of the preliminary data New York And Other place In America Seems to suggest hospitalization for smokers As low as, Leading to more and more calls for clinical trials like the French want to pursue.

Still, all scientists and tobacco control experts VICE repeatedly stressed that these are just hypotheses and cannot afford to collect perfect data at such a rapid pace. Everyone is double working to help before the final creation of a vaccine. There may be other reasons unrelated to nicotine, as the number of smokers infected with the coronavirus appears to be in and out of the hospital.

“Are there any reporting issues?” Said Derek Yock, chairman of the Foundation for a Smokeless World and former executive director of non-communicable diseases and mental health at WHO. “Are they dying before going to the hospital? Are they not correctly classifying their smoking status? I want to be as skeptical as possible.”

As Yach admitted, there are many reasons to exist. The medical system can be overwhelming and the history can simply not be recorded correctly. Also, other chemicals in tobacco, rather than nicotine, may provide protective effects. And because nicotine enters the blood differently via cigarettes and nicotine patches, the proposed French trial may be flawed from the start.

While nicotine reaches its “peak” in the body, nicotine patches maintain much more persistent levels, and Jed Rose, professor of psychiatry and behavioral sciences at Duke University and co-inventor of nicotine skin patches, said explained.

Michael Siegel, a professor of community health sciences at Boston University, was particularly concerned about French research and remained vigilant overall.

“Smokers who developed a chronic condition probably quit because of the condition,” Siegel said. “Many smokers who continue to smoke do so because they are not yet ill, so this is expected to bias the inpatient sample towards those who do not smoke.”

But ironically, if nicotine was found to have a protective effect on the coronavirus, world public health officials have advised people to quit altogether since the beginning of the pandemic. tobacco And The difference between quit nicotine and tobacco (often lumped together and deviled) was highlighted by tobacco control experts focused on mitigating harm. Obtaining nicotine fixatives from safer than traditional cigarettes is important in smoking cessation methods, Foundation of tobacco harm reduction research.

Now it is potentially gaining new urgency.

“If you call things wrong, you can kill people,” Bates said.

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This article was originally published in VICE US.