Vapouround Magazine ISSUE 29 | Page 96

N F E R H FEATURES SAYING THE Unsayable More and more evidence suggests that nicotine may help prevent COVID-19 Words: Gordon Stribling Moments of hope have been few and far between during this pandemic. Even as infections steadily decline the ever-present fear of a second peak is never far from our minds, especially in the UK, which has one of the highest COVID-19 mortality rates in the world. But one unlikely ally in the fight against coronavirus emerged relatively early in the coronavirus saga: smoking (or, more precisely, nicotine). The idea that a deadly habit that's responsible for numerous respiratory conditions could make you less likely to contract COVID-19 is, shall we say, an uncomfortable one. But it's vital to emphasise that it is the nicotine, not the tobacco itself, that has shown promise. So what is going on here? ACE2 receptor ACE2 receptors are found on the surface of many cells and serve as an entry point to allow the coronavirus to enter and infect cells. Some scientists have speculated that nicotine lowers ACE-2 expression, which makes it harder for the virus to enter cells and cause infection. However, this conflicts with studies that found that nicotine enhances the action of the ACE-2 receptor, which suggests that smokers and nicotine consumers could be at higher risk of contracting COVID-19. In a paper published on May 9, Dr Konstantinos Farsalinos of the University of West Attica, Greece, said: "Up-regulation of ACE2, though seemingly paradoxical, may in fact protect patients from severe disease and lung injury." Cytokine storm When the body detects an infection, one of the natural responses is to produce biological chemicals called cytokines which signal the immune system to kick in and fight the infection. However sometimes the body’s cytokines production runs out of control (a cytokine storm) to the extent that it produces serious inflammation and cell damage which can cause serious injury or death. Excessive cytokine production is thought to be a factor in many of the more severe cases of COVID-19 and as nicotine has been shown to inhibit cytokines, it could theoretically help prevent COVID-19. Dr Farsalinis wrote in the journal Internal and Emergency Medicine: 94 VM29