6 ms·
Low incidence of daily active tobacco smoking in patients with symptomatic C19
- rossdavidh 7y agoHypothesis: if you have any pre-existing lung conditions, you are more likely to quit smoking. In other words, if you're the sort with pre-existing conditions that make you more likely to be hospitalized if you get Covid-19, then you would be more likely to have quit smoking (or died before now if you didn't). Still an interesting result, but not, needless to say, a reason to start smoking.
- snikeris 7y agoI find it interesting that smoking itself isn't a pre-existing condition that makes you more likely to be hospitalized if you get Covid-19.
- rossdavidh 7y agoSame here, although I already suspected it based on the fact that Japan's death total is very low; smoking is more prevalent in Japan than most advanced economies, I believe.
- justizin 7y agoengaging in a risk factor is not a condition.
- locusofself 7y agoI'd say being addicted is a condition of sorts
- greggturkington 7y agoa history of smoking is a condition
- zxexz 7y agoDepends on what you mean as a "condition". In a medical record, smoking status is often stored as a top-level value tied directly to the patient, and also often coded into their condition list[0]. In the FHIR standard, a physician's observation of a patient's smoking history is usually represented with an observation resource, but often will be "upgraded" to a condition resource[1]. But, yeah, from a non-healthcare data standpoint, what a "condition" is really just depends on your definition. [0] https://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F17-/F17.210 https://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F17-... [1] https://www.hl7.org/fhir/condition.html https://www.hl7.org/fhir/condition.html
- 013a 7y agoIs obesity a condition? How about "engaging in overeating"?
- ajross 7y agoIt's important to be careful here: the finding above is with symptomatic covid, not hospitalization. We don't know whether or not it makes you more likely to be hospitalized.
- tutuca 7y agoOr that you disregard some symptoms as normal because your smoking habit: coughing, dry throat, etc.
- ajross 7y agoRight, or that there's some other confounding factor that leads smokers to be less likely to contract the disease or seek treatment. This kind of science (teasing data out of uncontrolled sampling) is really hard.
- evancox100 7y agoI believe they raised and tried to address this confounding factor by determining whether or not one is a smoker based on a date prior to COVID-19 hitting. But I only skimmed it, so can’t be sure what they did.
- snikeris 7y agoInteresting, they hypothesize that nicotine is responsible: > There are however, sufficient scientific data to suggest that smoking protection is likely to be mediated by nicotine. SARS-CoV2 is known to use the angiotensin converting enzyme 2 (ACE2) receptor for cell entry[14-16], and there is evidence that nicotine modulates ACE2 expression[17]which could in turn modulate the nicotinic acetyl choline receptor (manuscript submitted).
- cat199 7y agoNot in medical field, but nicotine is generally biotoxic and used as a pesticide so i'm not at all surprised. Detriments to any symbiotic microorganisms aside, regularly spraying the lungs and other airways with a light coating of biotoxic film seems a good way to generally inhibit replication or damage any negative bioparticles, so long as the damage doesn't overwhelmingly interfere with the smoker's own biological functions and weaken the overall system ...
- bobchops 7y agoBeing toxic to an insect or human doesn't mean it will have any effect on a virus. IIRC the reason nicotine is poisonous to humans is because it binds to receptors involved in nerve function, which in turn are required to control muscles.
- vernie 7y agoSo start taking nicotine lozenges as a prophylactic?
- catalogia 7y agoWould orally ingested nicotine protect lungs the same way that inhaled nicotine does?
- 013a 7y agoIts far to premature to even conclude that inhaled nicotine protects the lungs. This is just one study. Don't do anything stupid, like go develop a nicotine addiction, just because of one headline.
- drewcoo 7y agoIt doesn't seem to take the social aspects of smoking into account. In a sense, smokers were already doing social isolation. I'd bet that people who scream on street corners are less likely to contract it than people who spend time quietly on street corners.
- cat199 7y agodigs aside, this is highly culturally dependent - before smoking was quasi-taboo in the west, smokers were often more social and smoking was a 'good' way to meet people - just join the local smoking circle outside. Same is likely still true in less smoking hostile countries.
- boomboomsubban 7y agoWhile non-smokers may try to avoid smokers, smokers frequently end up quite close to other smokers in any designated smoking area.
- whoisjuan 7y agoThe study is done with a Covid positive population. They didn’t study if people who smoked where less likely to get Covid. The study goal, as I understand it, was to theorize the idea that smoking serves as some sort of protection leading to less severe symptoms. Otherwise the study wouldn’t make sense. The study must have clearly accounted for ratios in the smoking general population against the sample population. That’s the only way it makes sense. I’m curious what makes you think that smokers isolated earlier than anyone else. I don’t think being a smoker makes you more self-aware of your own health. If anything is quite the contrary.
- gridlockd 7y agoThe OP does have a point. You cannot control for the social isolation factor because there is no data on it. The people who isolate with 100% success never get COVID and thus are missing from the sample population. It is also easier to isolate than to give up smoking.
- 12xo 7y ago
- baron_harkonnen 7y agoI was joking the other day that it would be funny if the reason that Covid19 was less sever in Asian countries was not the high rate of mask usage but the high rate of smoking!
- phillnom 7y agoSo, smoke em if you got em?
- gridlockd 7y agoSmoking may well have some hormetic effects, being a non-smoker is a risk factor in a handful diseases.
- gregwebs 7y agoIt would make sense if smoking (the oxidants from smoke) kills the virus. However, once the infection actually progresses it is clear that smokers are worse off. https://chrismasterjohnphd.com/covid-19/covid-19-and-the-smoking-paradox https://chrismasterjohnphd.com/covid-19/covid-19-and-the-smo...
- raverbashing 7y agoActually in the article there's a different proposed explanation related to nicotine and its withdraw when in an hospital setting.
- gregwebs 7y agoThe nicotine explanation in the article discussion isn't actually studied, it is just pure speculation (which is fine, mine is as well). But there's no explanation why there's fewer smokers even though smokers have more ACE2 receptors. That's table stakes for having a hypothesis on this.
- LatteLazy 7y agoI find it fascinating how willing people are to accept the vital importance of chemicals not directly related to covid 19 or coronaviruses. People were very willing to swallow Chloroquine as a "cure" or treatment, but that is (was?) used for treating malaria (not a virus). Now tobacco smoke is preventative? And that must be because of nicotine. Not one of 1000s of other chemicals in the same smoke? And forget that other research found smoking increased the density of the proteins covid 19 binds to to enter cells (another small study with unverified results I think). Jesus people, the solution to this problem will not be as simple as antimalarials or taking up Cuban cigars. Stop grasping at straws like they are lifeboats!
- ebg13 7y agoThis has nothing to do with "accept the vital importance of chemicals" and everything to do with the fact that we record smoker status when patients enter hospitals and HOLY COW, LOOK, A TREND IN THE DATA. > Now tobacco smoke is preventative? Maybe! If you just casually ignore data, you will miss opportunities for important discovery. > And that must be because of nicotine. Not one of 1000s of other chemicals in the same smoke? That's called a _hypothesis_. Hypotheses are somewhat important for research.
- LatteLazy 7y agoNow you're in trouble. You named a hypothesis but the experiment doesn't test that hypothesis does it? No one checked whether any or all of these people actually smoked. Weirdly they let them report different levels of smoking but don't include that data And no one thought to ask about vaping (where there are far fewer chemicals and you would have a stronger case to pin point nicotine). Plus they included Chinese data which is mostly made up. And they excluded random arbitrarily groups (no ICU patients, maybe all the smokers went straight there?). A good experiment is one where you learn something. You prove or disprove your hypothesis. This paper doesn't mean anything. Like you say, the answer to the question si "maybe". Maybe nicotine helps, maybe it doesn't. Maybe literally any chemical helps, maybe it doesn't. Great, thanks for wasting everyone time...
- 7y ago
- billman 7y agoWell stick that in your pipe!
- LatteLazy 7y agoThis paper is terrible. There are errors in the abstract. It uses percentage of percentages to make results look important. It relies on self reporting when people are strongly encouraged to misreport. It excludes groups arbitrarily (no ICU patients, no one treated by certain departments). Its all about 1 hospital for a few weeks in one part of France. Its like a test paper to teach people to spot errors and weaknesses in papers.
- ebg13 7y ago> Its all about 1 hospital for a few weeks in one part of France. We already have similar results from hospitals all over China. This is gravy. Read the "smoking history" section of Table 1. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 and compare it to smoking rates in China over the past several decades.
- LatteLazy 7y agoWe don't have any data for China. None of their numbers are reliable, they make them up. This is one of the biggest issues in this pandemic: we don't know shit partly because China insist on lying...
- ebg13 7y ago"...and therefore they have a strong undeclared interest in making it look like smoking inversely correlates with infection." Citation needed.
- LatteLazy 7y agoDid you reply to the wrong comment? I only know they're making number up, that's well documented... Citation for the fairness of Chinese numbers: https://foreignpolicy.com/2020/04/01/china-coronavirus-official-figures-underreporting-pandemic-response-xi-jinping/ https://foreignpolicy.com/2020/04/01/china-coronavirus-offic... Also: https://www.theguardian.com/world/2020/apr/17/china-denies-cover-up-as-wuhan-coronavirus-deaths-revised-up-50 https://www.theguardian.com/world/2020/apr/17/china-denies-c...
- scandox 7y agoThere is a story from the Golden Age of Science Fiction called Pandemic by JF Bone. It postulates a global virus the cure for which in the end turns out to be smoking tobacco. And the improbably beautiful nurse marries the curmudgeon who is her boss. And they put babies in smoke ventilators.
- 11235813213455 7y agoThat's maybe because someone who has a "strong enough health" to tolerate smoking, builds some resistance in the short term. That's in the long term that smoking is really deadly though That kind of study would also find out that people doing daily physical exercise would be much less affected by Covid, etc..
- jholdn 7y agoIt's an interesting data discrepancy - fewer smokers in covid-19 infected individuals - but it doesn't tell us much. The survival bias is a problem. They took the smoking status of alive patients, not in the ICU. The results could indicate the opposite effect. Smokers tend to be in the ICU or die at an accelerated rate so are under-represented. That said, one would expect counter-acting effects in such a situation that would make the counter-intuitive result of fewer smokers meaning it's worse for smokers less likely, e.g. greater diagnosis rate in smokers due to increased severity, higher rates of infection in smokers, etc. I don't think any conclusions can be drawn from this study. It does suggest that there is value in investigating the impacts of smoking on Covid-19.