Smoking and COVID-19 infection

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            For the infection from the new coronary artery, the data are not yet clear, the teachers note. However, smoking did not appear to be a risk factor for infection with the virus, but was associated with an increased risk of serious illness and the need for mechanical support.
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           <p style="text-align: justify;">The main findings of the study on tobacco use and infection by the new coronavirus, published in The Lancet Respiratory Medicine on May 25, are summarized by doctors at the Medical School of the National School of Medicine and Kapodistrian University of Athens, Maria Gavria. Danasis and Thanos Dimopoulos (Rector of EKPA).

Smoking can cause 50% of deaths and complications in smokers, while also putting a significant strain on health systems. During a pandemic, the possibility of an acute respiratory infection in smokers becomes topical. That’s why prevention measures and support measures to stop smoking are becoming more important at this time, the three professors say. The risk of infection is multiple in the lower and middle socioeconomic strata during pandemic periods. Some countries, such as South Africa and India, have banned the sale of tobacco during the lockdown period to limit the spread of the virus. The effectiveness of this practice has not yet been scientifically substantiated. Several mechanisms have been described that may increase the risk of respiratory infections in smokers.

Smokers have an affected immune system that affects the function of macrophages and are therefore more vulnerable to infections, for example they are twice as likely to be infected with the mycobacterium tuberculosis infection. In addition, the risk of infection with mycoplasma, legionella, pneumococcus and influenza is about 3-5 times higher in smokers. Data from previous epidemics with MERS and SARS viruses are not entirely clear. A study by Korea found that the risk of mortality was 2.55 times higher for smokers, but the study included a small number of patients. For the infection from the new coronary artery, the data are not yet clear, the teachers note. They add that in a recent review, smoking did not appear to be a risk factor for infection with the virus, but was associated with an increased risk of serious illness and the need for mechanical support. Another meta-analysis, however, did not show a correlation with severe disease. The largest study to date by the UK reports a 1.25-fold increased risk of death in smokers compared to non-smokers. This data may be due to overexpression of the angiotensin ACE2 receptor in smokers. However, it has not been shown that modifications in the receptor expression and bioavailability may affect mortality. Data from France suggest that smoking may have a protective effect against viral infection through interaction with acetylcholine receptors, but this data has not been proven and should in no way motivate the onset of smoking, they point out. Data on the likelihood of infection in those who use e-cigarettes have not been established.

They emphasize that all smokers should be encouraged to quit smoking and receive psychological and medical support. Prohibiting the sale of tobacco does not seem to be a solution because it usually leads to the flourishing of the by-trade. Smoking cessation will not only help in the short term, during the epidemic period, but will also reduce the long-term complications of smoking.

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