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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:
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