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- Title
Smoking, Nicotine, and COVID-19: Triangulation of Methods and Preregistration Are Required for Robust Causal Inference.
- Authors
Perski, Olga; Simons, David; Shahab, Lion; Brown, Jamie
- Abstract
Google Scholar PubMed OpenURL Placeholder Text WorldCat 7 Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS-CoV-2 infection, hospitalization and mortality from COVID-19: a living rapid evidence review with Bayesian meta-analyses (version 7). Figure 1 presents two of these, the first from smoking and/or nicotine to SARS-CoV-2 infection (panel A) and the second, once infected, from smoking and/or nicotine to severe disease and death (panel B). A recent collection of articles in I Nicotine & Tobacco Research i ,[1] dedicated to the potential adverse or protective effects of smoking and/or nicotine use on COVID-19 outcomes, highlighted a priori biological and behavioral reasons as to why smoking status may be expected to influence COVID-19 infection, disease severity, and mortality.[2],[3] For example, SARS-CoV-2 gains cell entry via the ACE-2 receptor, with elevated ACE-2 receptor levels observed in tobacco smokers - although reduced levels have also been reported.[4] At the same time, nicotine is an agonist of the cholinergic anti-inflammatory pathway, which may protect against a hyperinflammatory response to the virus, potentially preventing severe disease and/or mortality in smokers and/or nicotine users.[5] On the other hand, smoking causes respiratory and cardiovascular diseases that are associated with worse COVID-19 outcomes.[6] However, it was concluded that we currently have "more questions than answers", with a need for additional, high-quality research.[[1], [3]] More than a year into the COVID-19 pandemic and several months since the publication of the abovementioned article collection, answers are still few and far between.
- Subjects
CAUSAL inference; NICOTINE; COVID-19; TRIANGULATION; NICOTINIC acetylcholine receptors; CORONAVIRUS diseases
- Publication
Nicotine & Tobacco Research, 2023, Vol 25, Issue 2, p356
- ISSN
1462-2203
- Publication type
Article
- DOI
10.1093/ntr/ntab214