The US data from CDC is... well shocking. Almost literally unbelievable.pic.twitter.com/kwJr3RVWlg
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This is a surprising result. Smokers are far LESS likely to be hospitalized with COVID-19 that non-smokers and it looks robust across countries. Why might this be?https://twitter.com/KlausKblog/status/1249048902495592450 …
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Only 1.3% of U.S. COVID-19 cases are current smokers. Only 2.3% are former smokers.
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Possible explanation? Nicotine lowers ACE2 expression. (SARS-CoV-2 uses ACE2 for entry into target cells.) https://ncbi.nlm.nih.gov/pmc/articles/PMC6295500/ …pic.twitter.com/Jg1u0ynUzu
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One major New York hospital system that has released its data has a lot more smoking than the CDC data, but notably they have the odds ratio for tobacco use at less than 1.https://twitter.com/leorahorwitzmd/status/1249319859378405377 …
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Contra the theory above, a study from China finds higher ACE2 expression in smokers.https://www.medrxiv.org/content/10.1101/2020.03.18.20038455v1 …
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Question for the biochemists... *if* (big if!) there is a nicotine protective effect, is there an analog or derivative that could produce the same effect without the harms of nicotine?
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Another more complex theory of the potential mechanism, this one more consistent with the recent study in China.https://twitter.com/TrevorSutcliffe/status/1249767401899454470 …
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Several respondents have pointed me to this paper coauthored by Dr. Raymond Niaura, Interim Chair of the Department of Epidemiology at NYU. https://www.qeios.com/read/article/561 …pic.twitter.com/xd8JG8fs4C
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Should note this disclaimer on the U.S. data from CDC. Let's see what the next update looks like.pic.twitter.com/0OTC8qzTNz
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There's a preprint on that French hospital data now.https://twitter.com/KlausKblog/status/1252418954435256326 …
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Another French pre-print outlining a potential mechanism for a nicotine protective effect.https://www.qeios.com/read/article/581 …
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The theory of a nicotine protective effect is going to be tested in French hospitals using nicotine patches on health workers and patients.https://www.theguardian.com/world/2020/apr/22/french-study-suggests-smokers-at-lower-risk-of-getting-coronavirus?CMP=share_btn_tw …
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More U.S. data. Covid-19 Testing, Hospital Admission, and Intensive Care Among 2,026,227 United States Veterans Aged 54-75 Years "Smoking, COPD, and alcohol use disorder were associated with a LOWER probability of a positive test." https://www.medrxiv.org/content/10.1101/2020.04.09.20059964v1.full.pdf …pic.twitter.com/XSs2v1gmDZ
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The French high school study: Smokers had a lower IAR compared to non-smokers (7.2% versus 28.0%, P <0.001).https://www.medrxiv.org/content/10.1101/2020.04.18.20071134v1 …
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Here's a new twist. Huge UK study finds slightly lower COVID mortality risk among smokers than non-smokers, but highest among ex-smokers. https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1 …pic.twitter.com/segbKLJWEn
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And yet ignored it is.https://twitter.com/gbentley1/status/1259873136562094088?s=19 …
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New study from Israel: "The magnitude of association observed for current smoking, with odds of infection reduced by about a half in smokers, suggests a genuine protective effect of smoking on the risk of COVID-19."https://www.jpost.com/health-science/more-studies-point-to-nicotine-as-a-potential-therapeutic-for-covid-19-630576 …
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Just 0.7% of COVID deaths in South Carolina were current smokers. https://scdhec.gov/sites/default/files/media/document/COVID19_Comorbidities_6.30.20.pdf …pic.twitter.com/fAKmC1lqD3
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That new Lancet comparative study has a rate ratio under 1 for smoking prevalence. That means less COVID critical cases and deaths in countries with more smokers. https://www.thelancet.com/action/showPdf?pii=S2589-5370%2820%2930208-X …pic.twitter.com/FJ6TkPfaVG
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