Nicotine therapies showing tremendous promise as possible COVID therapeutic

Approximately 25 percent of French citizens are active, daily smokers.  Since smoking is long considered to increase the health risks of contracting respiratory diseases including emphysema and bronchitis, medical experts in France were understandably surprised when the first coronavirus statistics were reported in the early days of the pandemic. 

Researchers reviewing data compiled from the Pitié-Salpêtrière hospital in Paris noted that only five percent of the initial 482 COVID-19 patients hospitalized between February 28 to April 9, 2020, were regular smokers.  While comparative ratios varied slightly in China, the United States, and even other regions of France, the numbers followed a parallel trend.

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The percentages of smokers being admitted to the hospital for severe coronavirus symptoms seemed to be dramatically underrepresented.  According to The Economist, authors of the Pitié-Salpêtrière research write that smokers “are much less likely” to suffer as severely as non-smokers from sars-cov-2 – the underlying virus that is said to cause COVID-19.  The discovery is considered a true rarity in scientific research.

The Pitié-Salpêtrière nicotine and COVID-19 study

The Pitié-Salpêtrière-associated study entitled Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19 was first published in the international medical journal Qeios on April 21.  In addition to tracking French COVID patients, the co-authors conducted similar analysis involving “the middle-aged Chinese population.” After extensive investigation, the Pitié-Salpêtrière report shares the below findings.

“The inpatient group was composed of 343 patients, median age 65 yr: 206 men (601%, median age 66 years) and 137 women (39.9%, median age 65 years) with a rate of daily smokers of 4.4% (5.4% of men and 2.9% of women).The outpatient group was composed of 139 patients, median age 44 years: 62 men (44.6 %, median age 43 years, and 77 women (55.4 %, median age 44 years). The daily smokers rate was 5.3% (5.1% of men and 5.5 % of women). In the French population, the daily smokers rate was 25.4% (28.2% of men and 22.9% of women).
“The rate of current daily smokers was significantly lower in COVID-19 outpatients and inpatients (80.3% and 75.4%, respectively), as compared to that in the French general population with standardized incidence ratios according to sex and age of 0.197 [0.094 - 0.41] and 0.246 [0.148 - 0.408]. These ratios did not significantly differ between the two groups (P=0.63).”

Smokers, the report suggests, “are much less likely” to suffer severely from sars-cov-2, the virus that causes covid-19. This discovery is considered a rarity in the fields of medical research. However, the data also indicates that smoking does not diminish the risks of initially contracting the virus.  Smokers were simply found to be far less likely to require hospitalization.

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 Of course, the co-authors are not suggesting that everyone start smoking.  With the endorsement of the Health Minister of France, the organizations behind the writing of the study – the Sorbonne and the Pasteur Institute – are now conducting new clinical trials to determine if nicotine patches might act as a worthy therapeutic against the coronavirus.  If successful, nicotine treatments through vaping may be the next logical step.

The French are beginning by offering nicotine transdermal therapies to essential workers like nurses and doctors, a sampling of hospitalized patients diagnosed with COVID-19, and even a number of “ordinary citizens.”

The scientific hypothesis is that nicotine does not directly kill the sars-cov-2 virus, but it might bind itself to a certain protein in the body called ace2.  It is this protein that the virus initially attaches itself to, which in turn, causes the coronavirus infection. 

The hope is that the nicotine-enhanced protein essentially blocks or reduces the amount of infection.  Nicotine also has documented anti-inflammatory properties, which may also come into play either directly or indirectly.

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