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Smoking and COVID-19: What we know so far - 12/02/21

Doi : 10.1016/j.rmed.2020.106237 
Madhur D. Shastri a, , Shakti D. Shukla b, Wai Chin Chong c, Rajendra KC d, Kamal Dua e, Rahul P. Patel a, Gregory M. Peterson a, Ronan F. O'Toole f,
a School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia 
b Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and the University of Newcastle, Callaghan, Australia 
c Department of Molecular and Translational Science, Monash University, Clayton, Australia 
d Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Tasmania, Australia 
e Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo NSW, Australia 
f Department of Pharmacy and Biomedical Sciences, School of Molecular Sciences, College of Science, Health and Engineering, La Trobe University, La Trobe, Australia 

Corresponding author.∗∗Corresponding author.

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Abstract

The ongoing COVID-19 pandemic has placed a spotlight on infectious diseases and their associations with host factors and underlying conditions. New data on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus are entering the public domain at a rapid rate such that their distillation often lags behind. To minimise weak associations becoming perceived as established paradigms, it is imperative that methodologies and outputs from different studies are appropriately critiqued and compared. In this review, we examine recent data on a potential relationship between smoking and COVID-19. While the causal role of smoking has been firmly demonstrated in regard to lung cancer and chronic obstructive pulmonary disease, such associations have the benefit of decades’ worth of multi-centre epidemiological and mechanistic data. From our analysis of the available studies to date, it appears that a relationship is emerging in regard to patients with a smoking history having a higher likelihood of developing more severe symptoms of COVID-19 disease than non-smokers. Data on whether COVID-19 has a greater incidence in smokers than non-smokers is thus far, contradictory and inconclusive. There is therefore a need for some caution to be exercised until further research has been conducted in a wider range of geographical settings with sufficient numbers of patients that have been carefully phenotyped in respect of smoking status and adequate statistical control for confounding factors.

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Highlights

A history of smoking is significantly associated with a range of respiratory illnesses including COPD and lung cancer.
Meta-analyses of available data indicate that people with a smoking history are likely to acquire severe COVID-19 outcomes.
Studies are required to establish a role for smoking in susceptibility to SARS-CoV-2, and COVID-19 disease progression.
Mechanisms underlying the potential links between smoking and COVID-19 need to be addressed via new experimental research.

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Keywords : Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Smoking, Angiotensin-converting-enzyme (ACE)-II, Therapeutic targets


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Vol 176

Article 106237- janvier 2021 Retour au numéro
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