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Coronavirus UK: More ‘weird’ proof smokers may be at less risk more evidence smoking may cut the risk of coronavirus

Maybe this virus was released from a lab.

If I was studying a coronavirus, in a top secret research facility, and I discovered that if it was to be ‘accidently’ released into the human population, it would kill more non-smokers than smokers… 🤔 “whoops… That vase just slipped off my desk! How clumsy of me.” … Better get the cleaner in to mop it up. He’s out on a cigarette break? I think I’ll join him 😎🚬 It would make sense. Tobacco is a powerful plant medicine, that’s been used by indigenous and ancient cultures all over the world for thousands of years. From North to South America, to China and far East, to Middle East. It’s been prescribed and used in moderation for treating a range of diseases and ailments… It’s only in the last century, the ‘white man’ has taken it, commercialised it and turned it into one of the biggest killers in the world. Coronavirus UK: More ‘weird’ proof smokers may be at less risk MORE evidence smoking may cut the risk of coronavirus: Review of 28 studies shows number of smokers among hospitalised patients is ‘lower than expected’ as expert admits the mounting findings are ‘weird’ By Vanessa Chalmers Health Reporter For Mailonline14:29 28 Apr 2020, updated 16:03 28 Apr 2020 UCL reviewed 28 studies from China, US, France, South Korea and the UK It found smokers were less common than expected among COVID-19 patients  Researchers said there data on smoking is not to a high standard and has holes But it’s not the first time the unexpected link has been spotted by scientists  One expert said ‘something weird is going on with smoking and coronavirus’ Here’s how to help people impacted by Covid-19 A review of scientific studies has added more evidence to the claim that people who smoke might have a lower risk of becoming seriously ill with COVID-19. University College London academics looked at 28 papers and found the proportions of smokers among hospital patients were ‘lower than expected’. ADVERTISEMENT One public health professor said there was ‘something weird going on with smoking and coronavirus‘ and experts are struggling to explain the connection. One of the studies showed that in the UK the proportion of smokers among COVID-19 patients was just five per cent, a third of the national rate of 14.4 per cent.  Another found in France the rate was four times lower. In China, a study noted 3.8 per cent of patients were smokers – despite more than half of the population regularly smoking cigarettes.    When smokers do get diagnosed with the virus, however, they appear to be more likely to get so sick that they need ventilation, two studies in the review showed. Researchers admit that hospitals are probably not recording patientssmoking status properly, potentially because they are too busy, patients are too sick to answer, or because people lie in their answers.  But they are struggling to knock down mounting evidence suggesting an apparent protective effect given by cigarettes, which one expert today admitted was ‘weird’.  A review of five early studies on the topic last month made the exact same conclusions – that smokers may avoid serious infection, but their outlook is worse if they do.  University of College London reviewed 28 studies and found smoking rates were lower than expected among COVID-19 patients. The graph shows the smoking rate of each country against the percentage of smokers among COVID-19 patients. The lowest figure has been chosen for each country to show the stark comparison discovered by some studies Curiously, fewer than 10 per cent of hospital admissions were smokers – more than a third less than the national rate of 14.4 per cent (stock image) Two of the authors on the recent UCL review received research grants from smoking cessation lobbies. Their paper was titled ‘The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review’ and was published on the study-sharing website Qeios.   David Simons and colleagues looked at 28 studies involving more than 23,000 people.  Twenty-two of the studies were conducted in China, three in the US, one in South Korea, one in France and one was an international study using mostly UK data.  Only three of them split smoking status into three parts – current, former and never smokers.  ‘Notwithstanding these uncertainties, compared with national prevalence estimates, recorded current and former smoking rates in the included studies were generally lower than expected,’ the study authors wrote.  Data from the US suggests that smokers appear to be less likely to test positive for SARS-CoV-2 compared with never smokers.  Rather than this reflecting likelihood of catching the virus in the first place, it is more likely to point to someone’s risk of becoming so ill they have to go to hospital. Most of the countries involved in the studies did almost all of their testing in hospitals.  But the researchers noted that smokers were more likely to be tested, possibly because their symptoms, like a cough, are more obvious due to their habit.  ‘We would therefore caution against drawing any conclusion as to whether smokers are at increased risk of SARS-CoV-2 infection at this early stage,’ the UCL team said. Two high quality studies provided zero evidence that the 657 current or former smokers with the virus were at a higher risk of ending up in hospital. But among 1,370 people hospitalised across two other studies, smokers were 43 per cent more likely to see their disease progress to become severe than those who had never smoked.  Three studies reported death rates from COVID-19 but there ‘did not appear to be a notable difference’ between smokers and non-smokers. However, the studies ‘did not explicitly state never smoking status’, the authors said. They implied that patients who died may have smoked in the past, but this was not clearly recorded by a doctor.  The authors concluded there is a lack of evidence that meets a high standard to definitely say whether or not smokers are at higher risk of catching the coronavirus, or having poor outcomes. Data from the US suggests that smokers appear to be less likely to test positive for SARS-CoV-2 compared with never smokers. But the researchers noted that smokers were more likely to be tested – possibly because their symptoms are more obvious Three studies looked at hospitalisation for COVID-19 by smoking status. An analysis of two of these studies provided zero evidence that the 657 current or former smokers with the virus were at a higher risk of ending up in hospital Among 1,370 people hospitalised across two other studies, smokers were 43 per cent more likely to see their disease progress than those who had never smoked Three studies reported death rates from COVID-19 but there ‘did not appear to be a notable difference’ between smokers and non-smokers WHAT DID THE FIRST FIVE STUDIES OF SMOKERS WITH COVID-19 SHOW? A team of scientists at Harvard University in Boston and the University of Crete in Greece reviewed five of the first studies on links between smoking and COVID-19 in March. They found smokers do face a greater risk of suffering complications but others suggested they were less likely to be infected in the first place. In all of the studies, fewer than 15 per cent of the patients were smokers – a figure that clashes with China’s smoking rate, which is between 20 and 26 per cent and almost half of men.  The review of the evidence, led by Harvard’s Dr Constantine Vardavas, was published in the journal Tobacco Induced Diseases.  Here’s what it found:  STUDY 1  How many people were involved? 78 patients at 3 hospitals in Wuhan, China How many of them were smokers? Unclear Where were the results published? Chinese Medical Journal  What did it find? The patients who progressed  to severe illness had a ‘significantly’ higher number of smokers compared to the patients who got better – 27 per cent compared three per cent STUDY 2  How many people were involved? 1,099 at 552 hospitals across China How many of them were smokers? A total of 12.6 per cent (137) were current smokers and 1.9 per cent (21) were former smokers. Where were the results published? New England Medical Journal   What did it find? Among the 173 patients with severe symptoms, 16.9 per cent (29) were current smokers and 5.2 per cent (nine) were former smokers. In comparison, 11.8 per cent (108) of the 926 with milder symptoms were current smokers, and 1.3 per cent (12) were former smokers. In the group of patients that either needed mechanical ventilation, admission to an ICU or died, 25.5 per cent were current smokers and 7.6 per cent were former smokers. That was more than twice as high as the proportion of patients who did not need intensive care, 11.8 per cent of whom were current smokers and 1.6 per cent were former smokers. STUDY 3  How many people were involved? 140 in one hospital in Wuhan How many of them were smokers?  6.4 per cent were either current smokers (two) or past smokers (seven). Where were the results published? Allergy What did it find? Among the 58 patients who severely ill, 3.4 per cent (two people) were current smokers and 6.9 per cent (four) were former smokers. In comparison, of the 82 with milder symptoms, none were current smokers and 3.7 per cent (three) were former smokers.  STUDY 4:  How many people were involved? 191 in two hospitals in Wuhan How many of them were smokers? Six per cent (11 people) were current smokers Where were the results published? The Lancet What did it find? Among those that died (54), nine per cent (five people) were current smokers. Of those who survived, four per cent (six people) were smokers. STUDY 5 How many people were involved? 41 in one hospital in Wuhan How many of them were smokers? Seven per cent (three people) were current smokers Where were the results published? The Lancet  What did it find? None of the 13 patients who needed to be admitted to ICU were current smokers. In contrast, 11 per cent (three) of those who did not need intensive care were smokers. Commenting on the matter, Linda Bauld, a professor of public health at the University of Edinburgh, said ‘there’s something weird going on with smoking and coronavirus’. ADVERTISEMENT She told Good Morning Britain: ‘We know for decades that smoking is linked to a higher risk of developing respiratory conditions and also people who smoke have poorer outcomes.  ‘And we’ve still got around seven million smokers in the UK, [the] leading preventable cause of death. ‘However, my colleagues at UCL… what they’ve found is there are surprisingly few smokers in those studies who’ve developed coronavirus.  ‘In one French study, four times as many non-smokers got the virus and developed COVID-19 compared to smokers.   ‘There is a potential biological explanation for this.’ Professor Bauld said the way the virus enters the body may be blocked by effects of nicotine – the addictive compound found in tobacco.  The coronavirus enters cells inside the body via structures called ACE-2 receptors, which coat the surface of some cells, including in the airways and lungs.    The numbers of ACE-2 receptors someone has are thought to vary depending on genetics and some evidence suggests that they are higher in smokers. This could, in theory, put them at a higher risk of contracting the coronavirus.  However, the virus is known to cause lung damage by depleting the numbers of ACE-2 receptors, so the fact that smoking increases them could reverse the effect and prevent harm to the lungs. On the other hand, other studies show that nicotine reduces the action of the ACE-2 receptor, suggesting smokers are less likely to catch the virus in the first place. Professor Bauld said: ‘It’s plausible that smokers are less likely to develop the condition potentially because of nicotine. Importantly in that UCL review where smokers did develop COVID-19, their outcomes are far worse.’ A leading infectious disease expert at University College London, Professor Francois Balloux, has also previously said there is ‘bizarrely strong’ evidence smoking may be protective What did the studies from each country show?  The studies conducted in hospitals in China showed that 3.8 to 17.6 per cent of COVID-19 patients were current smokers and fewer than five per cent were former smokers.  However, 2018 data shows more than half the population of the country are current smokers (50.5 per cent of men and 2.1 per cent of women).   And almost one in 10 of non-smokers in China are former smokers (8.4 per cent of men and 0.8 per of women). In the US studies, 1.3 to 27.2 per cent were current smokers, in contrast to a smoking prevalence of 13.8 per cent in 2018. And 2.3 to 30.6 per cent were former smokers, compared with the 20.9 per cent of former smokers across the states. In the South Korean study, 18.5 per cent were current smokers, which almost matches the smoking prevalence of 19.3 per cent in 2016. In the included study conducted in France, 7.1 per cent were current smokers, 6.1 per cent of whom were hospitalised. But much higher smoking rates are recorded in the population –  32 per cent. However the results were different for former smokers, of which there are 31.4 per cent in France. A much higher 59.1 per cent of COVID-19 patients were former smokers.  In the international study with participants predominantly from the UK in a hospital setting, five per cent were current or former smokers.  This compares with a current and former smoking prevalence of 14.4 and 25.8 per cent in England in 2018, ‘suggesting a lower than expected proportion of current and former smokers in the included study’.  Typically, smokers are at a heightened risk of infection because the tiny hairs inside the airways and lungs, which help move pathogens and mucus away, are often damaged by the toxic chemicals in cigarette smoke. In theory, this would put smokers at a disadvantage if they catch coronavirus, considering the disease leaves patients unable to get enough oxygen into the bloodstream due to lung inflammation.  A group of studies from China found that the average proportion of coronavirus patients who were classed as smokers – from a total of almost 6,000 people – was just 6.5 per cent. For comparison, more than 26 per cent of the country’s population as a whole are smokers The largest study which analyses health profiles of patients is published in the New England Journal of Medicine: Of the 173 patients who had severe symptoms, 16.9 per cent of them were current smokers and 5.2 per cent had previously smoked. In comparison, of the patients with less-severe symptoms, 11.8 per cent were current smokers and 1.3 per cent were former smokers Researchers at the Zhongnan Hospital of Wuhan University made the conclusion that only 1.4 per cent of 140 hospitalised patients were smokers A study of 41 patients found that none of the 13 patients who needed to be admitted to ICU were current smokers. In contrast, 11 per cent (three) of those who did not need intensive care were smokers One study of 140 coronavirus patients found that among the 58 patients who severely ill, 3.4 per cent (two people) were current smokers and 6.9 per cent (four) were former smokers. In comparison, of the 82 with milder symptoms, none were current smokers and 3.7 per cent (three) were former smokers WHAT IS AN ACE-2 RECEPTOR AND WHAT DOES IT HAVE TO DO WITH COVID-19?  ACE-2 receptors are structures found on the surface of cells in the lungs and airways which work with an enyzme called ACE (angiotensin-converting enzyme) to regulate blood pressure. Its exact function in the lungs is not well understood but studies suggest it is protective against lung damage and low levels of it can worsen the impact of viral infections. Scientists say that the coronavirus which causes COVID-19 enters the body through the ACE-2 receptor, which the shape of it allows it to latch on to. This means that someone with more ACE-2 receptors may be more susceptible to a large viral load – first infectious dose of a virus – entering their bloodstream. ACE-2 receptors have a shape which matches the outside of the coronavirus, effectively providing it with a doorway into the bloodstream, scientists say People who have higher than usual numbers of ACE-2 receptors may include those with diabetes or high blood pressure because they have genetic defects which make them produce more. Emerging evidence shows that smokers may also produce more. High levels of ACE-2 receptors may also be protective, however. They are thought to be able to protect the lungs during infection and a study on mice in 2008 found that mice which had ACE-2 blocked in their bodies suffered more damage when they were infected with SARS, which is almost identical to COVID-19. Smoking has in the past been repeatedly linked to lower than normal levels of ACE-2 receptors, potentially increasing the risk of lung damage from COVID-19. Research has shown smokers do face a greater risk of suffering complications – but others suggested they were less likely to be infected in the first place.  That was the finding of the first large review of evidence by a team led by Harvard’s Dr Constantine Vardavas, Greece, published in the journal Tobacco Induced Diseases. The team reviewed five studies in March and said so far say the proof smoking raises the risk of coronavirus is limited, after finding as little as 1.4 per cent of hospitalised patients were smokers.  The group of experts even admitted warnings made by health chiefs were based mainly on assumptions, given the known infection risks of smoking.  A study published earlier this month by scientists in New York and Athens looked at 13 Chinese studies that had registered smoking as a precondition and found that the number of smokers across the whole sample of 5,300 patients was 6.5 per cent.  It’s an astonishingly small number in country where half of all men still smoke.  Another study, by America’s Centers for Disease Control of over 7,000 people who tested positive for coronavirus, found that just 1.3 per cent of them were smokers – against the 14 per cent of all Americans that the CDC says smoke. The study also found that the smokers stood no greater chance of ending up in hospital or an ICU.  Governments in both the UK and US urge people to stop smoking to protect themselves from the virus as a matter of precaution, while scientists admit there is no clear proof cigarettes can worsen the disease.  Recently, world-famous artist David Hockney wrote a letter to the Daily Mail saying: ‘I used to joke that being a smoker in Malibu was the equivalent of being a non-smoker in Pasadena. They used to have very bad pollution there. ‘Could it not be that smokers have developed an immune system to this virus? With all these figures coming out, it’s beginning to look like that to me.’   The British artist, now 82 and living in France, adds ‘I’m serious’ and has in the past revealed he’s smoked for more than 60 years but still considers himself healthy.  EARLY US DATA SHOWS JUST 1.3 PER CENT OF CORONAVIRUS PATIENTS ARE SMOKERS  Early data from America’s Centers for Disease Control and Prevention (CDC) showed that just 1.3 per cent of people diagnosed with COVID-19 were classified as smokers. From a sample of 7,162 of the nation’s earliest patients, just 96 were ‘current smokers’. Just 22 out of 1,037 patients in hospital were smokers, along with five out of 457 in intensive care, according to the data. This contrasts sharply with the CDC’s statistics that show 14 per cent of all Americans regularly smoke cigarettes. It is not clear whether there is a link between smoking and a lower risk of catching or falling ill with coronavirus, or whether recording of who smokes and who doesn’t isn’t up to scratch. University College London’s Professor Jamie Brown, a tobacco and public health expert, said he expects it to be the latter.  He told MailOnline: ‘It’s really difficult to assess how well smoking status has been recorded in an emerging epidemic and a lot of these people have been too sick to answer or may not have replied totally honestly. ‘We know, generally, smokers tend to come from lower income groups which have poorer access to healthcare and may be more likely to die in the commmunity.’  Data from the Centers for Disease Control and Prevention (CDC) in the US showed that of around 7,000 COVID-19 patients, former smokers were more likely to be hospitalised or taken into intensive care than current smokers ScienceHealth NEW FACT: Smokers’ lungs repulse Coronavirus? Nicotine acts as preventive agent, find studies Ever since the first case of Coronavirus emerged in China four months ago, countries all around the world are trying to contain the spread of the virus by imposing stricter measures such as social distancing and nationwide lockdown. The World Health Organization (WHO), which is monitoring the pandemic since the beginning, has asked people to follow specific safety measures to defeat the novel Coronavirus. The organization has advised people to quit smoking as the habit increases the risk of infection. But some recent research reports have claimed that the number of smokers among COVID-19 patients are much lower than expected. Now, new facts are emerging with additional claims against the vulnerability of smokers. Pixabay Nicotine prevents Coronavirus? The use of tobacco is thought to kill an estimated eight million people every year. But a study, by the Pitié-Salpêtrière Hospital in Paris suggested that “nicotine may be suggested as a potential preventive agent against COVID-19 infection,” based on scientific literature and the hospital’s own observations. It also mentioned that “current smoking status appears to be a protective factor against the infection by SARS-CoV-2.” Since, ACE-2 receptors in the airways act like doorway for virus into the body, nicotine blocks these receptors, making it difficult for coronavirus to bind with them and enter the blood. Thus, some researchers suggest that smokers have low chances of illness when infected with coronavirus because nicotine reduces the number of receptors which in turn block entry of virus into blood cells. Data on smokers reveal so Their study is based on data collected from 480 patients tested positive for COVID-19. Out of that 350 patients were hospitalized and only 4.4 percent were regular smokers with an average age of 65. Out of people who did not hospitalize 5.3 percent were smokers with an average age of 44. They noticed that very few smokers reported to test positive of the virus as nearly 40 percent of the general population smokes with a median age of 44 to 53. After this finding, French doctors have embarked upon a plan to give nicotine patch to coronavirus patients as there are low rates of smokers amongst the infected patients. It should be noted that this study also warned that “nicotine is a drug of abuse responsible for smoking addiction.” However, another French study conducted by the Pasteur Institute found that smokers were four times less likely to catch Coronavirus. This research, which included 700 participants, revealed that only 7.2 percent of those infected were smokers. There are many scientists who are trying to stop the new Coronavirus, insisting that smokers have low chances of illness when infected with COVID-19 because nicotine reduces the number of receptors which in turn block the access of virus into the blood. WHO differs but on different ground It is a well-known fact that smoking is one of the reasons behind lung cancer. In terms of Coronavirus, a Chinese research had claimed that smokers were 14 times more likely to develop serious complications, so there is no scientific consensus that smoking can prevent or lessen coronavirus spread. Citing its stand on smoking, WHO has warned people that: “The act of smoking means that fingers (and possibly contaminated cigarettes) are in contact with lips which increases the possibility of transmission of the virus from hand to mouth Smoking products such as water pipes often involve the sharing of mouthpieces and hoses, which could facilitate the transmission of COVID-19 in communal and social settings. “Smokers may also already have lung disease or reduced lung capacity which would greatly increase the risk of serious illness. Conditions that increase oxygen ne or reduce the ability of the body to use it properly will put patients at higher risk of serious lung conditions such as pneumonia.” Pixabay There are studies which claimed that smokers were more likely to die than non-smokers as per the experience during the Middle Eastern Respiratory Syndrome or MERS outbreak in 2012. As per the European Centre for Disease Control (ECDC), researchers have identified smokers as a “vulnerable group” to infection from COVID-19. ECDC also found a higher ACE2 gene expression in lung tissues, something increased by tobacco use. Recently, UK Health Secretary Matt Hancock said, “It is abundantly clear that smoking makes the impact of Coronavirus worse.” Professor Peter Pitts Meanwhile, IBTImes SG talked to former FDA Associate Commissioner Peter Pitts, who is the President and co-Founder, Center for Medicine in the Public Interest, an independent body for the study of health matters. When asked about the connection between smoking and COVID-19, he said: Smoking is the world’s #1 preventable health crisis. While anecdotal evidence does show that a small cohort of cigarette smokers and e-cigarette vapers have had better responses to COVID-19, the plural of anecdote is not data. However, it does point to yet reason why e-cigarettes are a far safer alternative to combustible smoking. On the other hand, University College London academics which looked at 28 research papers, found that the proportions of smokers among hospital patients were ‘lower than expected’. As per the experts, one of the studies showed that in UK, the proportion of smokers among Coronavirus patients was just five percent which is a third of the national rate of 14.4 per cent. While several studies have indicated that smokers are not exactly most vulnerable group when it comes to Coronavirus victims, experts said that there was “something weird going on with smoking and Coronavirus

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