Nicotine and the nicotinic cholinergic system in COVID‐19

Tizabi, Yousef; Getachew, Bruk; Copeland, Robert L.; Aschner, Michael

doi:10.1111/febs.15521

Cited by 53 publications

(60 citation statements)

References 96 publications

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“…Especially during this pandemic, cigarette smoking has been linked with the upregulation of angiotensin-converting enzyme-2 in lung cells ( 55 , 56 ) and weakened immune system ( 57 ); it was also reported that patients with smoking history were associated with more progressed COVID-19 symptoms ( 58 ). Moreover, cigarette smoking has been linked to aggravating neuropsychiatric symptoms, systemic inflammation, coagulation, and other clinical symptoms in COVID-19 patients through nicotine and nicotinic-cholinergic system interaction ( 59 , 60 ). The rising cigarette consumption in some respondents might be driven by factors other than psychopathologies, as neither significant difference in SCL-90 scores nor correlation in the regression analysis were seen.…”

Section: Discussionmentioning

confidence: 99%

Alcohol- and Cigarette-Use Related Behaviors During Quarantine and Physical Distancing Amid COVID-19 in Indonesia

et al. 2021

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Background: In light of the coronavirus disease 2019 (COVID-19) pandemic, Indonesia implemented large-scale social restrictions (pembatasan sosial berskala besar/PSBB) to combat the spread of COVID-19, which might influence addictive behaviors. The current study aimed to explore the fluctuation of substance use during the pandemic and association of physical distancing and related factors toward consumption of alcohol and cigarettes.Method: An online survey was conducted from April 28 to June 1, 2020. Data regarding sociodemographic information, physical distancing profile, alcohol and cigarette usages, Alcohol Use Disorders Identification Test (AUDIT), Cigarette Dependence Scale (CDS), Symptom Checklist-90, and Pittsburg Sleep Quality Index (PSQI) were collected. A total of 4,584 respondents from all 34 provinces in Indonesia completed the survey. Data were summarized descriptively and analyzed using chi-square, ANOVA, and multinomial regression on SPSS 23.0 for Windows.Results: This study found that during the COVID-19 pandemic in Indonesia alcohol consumption was 9.50% and daily cigarette smoking was 20.3%. Around 44.5% and 47.6% of respondents reported stable alcohol consumption and cigarette consumption, respectively. The mean AUDIT score was 3.52 ± 4.66 and the mean CDS score was 24.73 ± 8.86. Physical distancing was not correlated to any substance use changes. Increased alcohol consumption was negatively correlated with being unmarried and positively correlated with a higher PSQI score. Decreased alcohol use positively correlated with living in PSBB-implementing provinces and higher AUDIT scores when compared to stable alcohol drinking. Increased cigarette smoking was positively correlated with being male, unmarried, and higher CDS scores. Reduced cigarette smoking was negatively correlated with living in provinces implementing PSBB, higher CDS scores, and phobic anxiety, hostility, and psychoticism subscales of SCL-90.Discussion and Conclusion: The prevalence of alcohol and cigarette consumption changes showed a similar trend with other available studies in other countries. This study established that substance use was mainly sustained with a smaller proportion of respondents amplifying their substance usages. The changes were correlated with PSBB policy but not the practice of physical distancing. Psychiatry and addiction services in Indonesia should be strengthened to cope with the increased burden of psychological distress. Future studies should conduct more comparisons to determine whether the overall rising intensity of consumption was maintained post-pandemic and delineate acute psychopathologies' effects on substance use.

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Section: Discussionmentioning

confidence: 99%

Alcohol- and Cigarette-Use Related Behaviors During Quarantine and Physical Distancing Amid COVID-19 in Indonesia

et al. 2021

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“…It must also be considered that current smokers cease to be so when entering the hospital, as far as nicotine is concerned. In our work, we only refer to the fact that there are less hospitalised current smokers than expected, which is why nicotine has been suggested to very likely have a protective effect against serious symptoms, calming the cytokine storm (see Section 4.2, [36,38,43]). This might be a cause of underrepresentation among hospitalised patients.…”

Section: Limitations and Biasesmentioning

confidence: 99%

“…Most of them have been systematic reviews and meta-analyses focusing on the association between smoking, disease progression and severity of the outcomes for COVID-19 patients (largely showing a positive relation between these factors) [8,12,14,[24][25][26][27][28][29][30][31][32][33][34][35]. However, to the best of our knowledge, just a few works have focused on studying the low prevalence of current smokers within hospitalised COVID-19 patients-mainly found in clinical data from China outbreak reports or early USA data-and more importantly, proposing potential pathophysiological explanations for these findings [36][37][38][39][40][41][42][43]. In this sense, nicotine or nicotinic receptor agonists were early proposed as plausible anti-inflammatory mediators acting on the immune system to counteract the "cytokine storm" found in severe SARS-CoV-2 infected patients [43].…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Hospitalised Current Smokers and COVID-19

González-Rubio

Navarro-López

López-Nájera

et al. 2020

IJERPH

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SARS-CoV-2 is a new coronavirus that has caused a worldwide pandemic. It produces severe acute respiratory disease (COVID-19), which is fatal in many cases, characterised by the cytokine release syndrome (CRS). According to the World Health Organization, those who smoke are likely to be more vulnerable to infection. Here, in order to clarify the epidemiologic relationship between smoking and COVID-19, we present a systematic literature review until 28th April 2020 and a meta-analysis. We included 18 recent COVID-19 clinical and epidemiological studies based on smoking patient status from 720 initial studies in China, the USA, and Italy. The percentage of hospitalised current smokers was 7.7% (95% CI: 6.9–8.4) in China, 2.3% (95% CI: 1.7–2.9) in the USA and 7.6% (95% CI: 4.2–11.0) in Italy. These percentages were compared to the smoking prevalence of each country and statistically significant differences were found in them all (p < 0.0001). By means of the meta-analysis, we offer epidemiological evidence showing that smokers were statistically less likely to be hospitalised (OR = 0.18, 95% CI: 0.14–0.23, p < 0.01). In conclusion, the analysis of data from 18 studies shows a much lower percentage of hospitalised current smokers than expected. As more studies become available, this trend should be checked to obtain conclusive results and to explore, where appropriate, the underlying mechanism of the severe progression and adverse outcomes of COVID-19.

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“…Therefore, it would seem that smokers should be at an increased risk of both contracting COVID-19 and developing severe infection ( 7 ). The data have been mixed, with most studies suggesting that active smoking may predispose to infection and progression to severe disease ( 8 , 9 ) but a few studies (some unreviewed) suggesting that smokers may be protected from getting COVID-19 ( 10 – 12 ). However, nicotine itself has also been (separately) proposed as a potential therapeutic agent in COVID-19 because of its activation of nicotinic cholinergic receptors ( 8 ).…”

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confidence: 99%