The Paradoxical Relationship Between Nicotine and SARS-CoV-2 Infection: A Systematic Review

Maliha Majeed (1) , Gregory Lewis (2) , Catherine Olang (3) , Sasha Lake (4) , Vasavi Gorantla (5)
(1) Department of Anatomical Sciences, St. George’s University School of Medicine, Grenada, West Indies, Grenada ,
(2) Department of Anatomical Sciences, St. George’s University School of Medicine, Grenada, West Indies, Grenada ,
(3) Department of Anatomical Sciences, St. George’s University School of Medicine, Grenada, West Indies, Grenada ,
(4) Department of Anatomical Sciences, St. George’s University School of Medicine, Grenada, West Indies, Grenada ,
(5) Department of Anatomical Sciences, St. George’s University School of Medicine, Grenada, West Indies, Grenada

Abstract

Across the board, smoking is considered to be negative toward our health. While this information has been known for a relatively long time, the COVID-19 pandemic has stirred up a controversial idea: that smokers are protected from severe COVID-19 relative to non-smokers. This suggests that smoking is a helpful agent in the evolving fight against SARS-CoV-2, and impressionable individuals are at risk of starting to smoke as a means of protecting themselves from the virus. To address the validity of this claim, a systematic review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed was searched for relevant articles and the results were screened according to inclusion criteria. Our search yielded a total of 81 results and after removal of duplicates, non-English papers, and a quality appraisal a total of 16 papers were included in this review. We found that while smokers were more likely present with a less severe disease due to downregulation of severe cytokine storm, they were overall more likely to contract COVID-19 due to upregulation of ACE-2 receptors which SARS-CoV-2 uses to enter the cells of the respiratory epithelium. Also, long time smokers who develop COPD are more likely to have fatal outcomes from COVID-19 infection. Further, these results were due to the effects of nicotine and not cigarettes themselves. Since cigarettes contain numerous carcinogens, they are not recommended as a prophylaxis for COVID-19. However, we recommend that nicotine should be a topic for further research as potential therapy.

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References

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Authors

Maliha Majeed
Gregory Lewis
Catherine Olang
Sasha Lake
Vasavi Gorantla
vgorantl@sgu.edu (Primary Contact)
Maliha Majeed, Gregory Lewis, Catherine Olang, Sasha Lake, & Vasavi Gorantla. (2022). The Paradoxical Relationship Between Nicotine and SARS-CoV-2 Infection: A Systematic Review. International Journal of Research in Pharmaceutical Sciences, 13(1), 92–101. https://doi.org/10.26452/ijrps.v13i1.26

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