Review
SARS-CoV-2 infection and smoking: What is the association? A brief review

https://doi.org/10.1016/j.csbj.2021.03.023Get rights and content
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Highlights

  • The link between smoking and the expression of SARS-CoV-2 key entry genes is discussed.

  • Smoking-related cardiac and respiratory diseases are risk factors for COVID-19.

  • The impact of smoking on ACE-2 and TMPRSS2 receptors expression is controversial.

Abstract

Susceptibility to severe illness from COVID-19 is anticipated to be associated with cigarette smoking as it aggravates the risk of cardiovascular and respiratory illness, including infections. This is particularly important with the advent of a new strain of coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV-2) that has led to the present pandemic, coronavirus disease 2019 (COVID-19). Although, the effects of smoking on COVID-19 are less described and controversial, we presume a link between smoking and COVID-19. Smoking has been shown to enhance the expression of the angiotensin-converting enzyme-2 (ACE-2) and transmembrane serine protease 2 (TMPRSS2) key entry genes utilized by SARS-CoV-2 to infect cells and induce a ‘cytokine storm’, which further increases the severity of COVID-19 clinical course. Nevertheless, the impact of smoking on ACE-2 and TMPRSS2 receptors expression remains paradoxical. Thus, further research is necessary to unravel the association between smoking and COVID-19 and to pursue the development of potential novel therapies that are able to constrain the morbidity and mortality provoked by this infectious disease. Herein we present a brief overview of the current knowledge on the correlation between smoking and the expression of SARS-CoV-2 key entry genes, clinical manifestations, and disease progression.

Abbreviations

ACE2
angiotensin-converting enzyme-2
ACEIs
Angiotensin‐converting enzyme inhibitors
ADAM17
ADAM metallopeptidase domain 17
ALCAM
activated leukocyte cell adhesion molecule
Ang
angiotensin
ARBs
angiotensin receptor blockers
ARDS
acute respiratory distress syndrome
BatCoV
bat coronavirus
CLDN7
claudin 7
COPD
chronic obstructive pulmonary disease
COVID-19
coronavirus disease 2019
CTNNB1
catenin beta 1
ERK
extracellular signal-regulated kinases
HDAC6
histone deacetylase 6
HIV-1
human immunodeficiency virus 1
hrsACE2
human recombinant soluble ACE-2
IFN
Interferons
IPF
Idiopathic pulmonary fibrosis
IR
Ionizing radiation
JNK
c-Jun N-terminal kinase
MERS
middle-East respiratory syndrome
MCN
mucin
R0
R-nought
nAChR
α7 nicotinic acetylcholine receptor
NO
nitric oxide
RAS
renin-angiotensin
RR
relative risk
SARS-CoV-2
severe acute respiratory syndrome coronavirus
TJP3
tight junction protein 3
TMPRSS
transmembrane serine protease

Keywords

SARS-CoV-2
Coronavirus
COVID-19
Smoking
Lung disease
Oral disease

Cited by (0)

1

Both the authors contributed equally to this review.