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The researchers have uncovered more evidence that smokers may be protected against the deadly coronavirus.
Less than five percent of the 441 COVID-19 patients who needed to be admitted to an Italian hospital were smokers.
Scientists described it as a “very low” number, given that a quarter of the general population is known to be hooked on cigarettes.
It suggests that smokers are less likely to contract the disease, a theory that emerged in the last few weeks from several global studies.
But once smokers are in the hospital, they are more likely to see their disease progress rapidly and lead to death, according to some evidence.
The new study found that half of the infected smokers died, compared to 35 percent of the rest of the patients.
Experts are struggling to remove the growing evidence suggesting an apparent protective effect of cigarettes, which has been described as “strange.”
Two weeks ago, a literature review by University College London also found a ‘lower-than-expected’ smoking rate among COVID-19 patients.
Of the 28 studies analyzed, one from the UK revealed that only five percent of patients were smokers, a third of the national rate of 14.4 percent.
But health officials in the United Kingdom and the United States urge people to quit smoking to protect themselves from the virus as a precaution.
Researchers have uncovered more evidence that smokers may be protected from the deadly coronavirus. Less than five percent of the 441 hospitalized patients with COVID-19 in an Italian study were smokers, compared to 24 percent in the population
More smokers succumbed to the disease, almost half compared to 35 percent of those who had never touched a cigarette.
The Italian study led by Dr. Nicola Gaibazzi examined patients admitted to a hospital in Parma, northern Italy.
It means that the findings can only be applied to those with symptoms severe enough to seek medical attention: Thousands of patients escape any symptoms.
Information on smoking was taken from medical records and efforts were made to directly contact patients or their families for confirmation.
Previous research on the subject has been riddled with holes because researchers admit that data was missing.
But in this study, a total of 423 of 441 patients or their families were spoken to by phone, strengthening the data.
Overall, only 21 patients (4.8 percent) were active smokers, which is disproportionate compared to 24 percent of the population, according to the team.
Ten percent (44 people) had smoked previously, but clear data is missing to indicate how many Italians have completely quit.
Of the Italian cohort, which had an average age of 71 years, about 35 percent died. Men and patients with heart disease were at higher risk.
Non-smokers made up 85 percent of victims, smokers 6 percent, and ex-smokers 9 percent, which was not significantly different from the total cohort.
However, active smokers had a 50/50 chance of survival once hospitalized: 47 percent of those admitted died. In comparison, just over a third of nonsmokers died.
Non-smokers made up 85 percent of victims, smokers 6 percent, and ex-smokers 9 percent, which was not significantly different from the total cohort. However, active smokers had a 50/50 chance of survival once hospitalized: 47 percent of those admitted died. In comparison, just over a third of nonsmokers died
The underlying mechanisms that potentially protect smokers are still unclear.
But a theory disproved by scientists is that nicotine reduces ACE-2 receptors, which are proteins in the body that the virus binds to infect cells.
Dr. Gaibazzi has his own theory: He speculated that exposure to cigarette smoke and its chemicals reduces the body’s immune system over time, as measured by lower inflammatory markers.
Therefore, when smokers are infected with a virus such as SARS-CoV-2, their immune system is more “tolerant” and does not overreact.
On the other hand, nonsmokers may be more likely to have a sudden and fatal release of inflammatory markers when they are infected with the virus, known as “cytokine storm.”
Doctors have previously said that it is often the body’s response to the virus, rather than the virus itself, that plays an important role in a person’s illness.
Dr. Gaibazzi and the authors wrote: ‘Patients admitted with COVID-19 in an Italian hospital heavily involved in the recent outbreak showed a disproportionately low prevalence of active smokers compared to the general population.
“The current study is useful in that it suggests that smokers may carry some form of protective mechanism against symptomatic SARS-CoV-2 infection.”
The study was published on the MedRxiv prepress site and has therefore not been scrutinized by other scientists.
Smokers are generally at increased risk for infection because the tiny hairs inside the airways and lungs, which help flush out pathogens and mucus, are often damaged by toxic chemicals in cigarette smoke.
In theory, this would put smokers at a disadvantage if they contract the coronavirus, considering that the disease leaves patients unable to get enough oxygen into the bloodstream due to lung inflammation.
But data from around the world shows the opposite: that smokers are protected from infection in some way.
The team isn’t the first to suggest that smokers may be protected by their habit, after a series of studies have detected the unexpected link (stock image)
The University of College London reviewed 28 studies and found that smoking rates were lower than expected among COVID-19 patients. The graph shows the smoking rate for each country versus the percentage of smokers among patients with COVID-19. The lowest figure for each country was chosen to show the stark comparison uncovered by some studies
A review of scientific studies by academics at University College London also found that the proportions of smokers among hospital patients were “lower than expected.”
His article was titled, ‘The Association of Smoking with SARS-CoV-2 Infection, Hospitalization, and COVID-19 Mortality: A Review of Quick and Living Evidence’ and was published on the Qeios website to share studies in April.
David Simons and colleagues analyzed 28 studies with more than 23,000 people.
Twenty-two of the studies were conducted in China, three in the USA. One, one in South Korea, one in France, and one was an international study using data mainly from the UK.
The study of the EE. USA He suggested that smokers appear to be less likely to test positive for SARS-CoV-2 compared to never smokers.
Rather than this reflecting the likelihood of contracting the virus in the first place, it is more likely to point to the risk of someone getting so sick that they have to go to the hospital. Most of the countries involved in the studies performed almost all of their tests in hospitals.
But the researchers noted that smokers were more likely to be tested, possibly because their symptoms, such as a cough, are more evident because of their habit.
Two high-quality studies provided zero evidence that the 657 current or former smokers with the virus had an increased risk of ending up in the hospital.
But when smokers are diagnosed with the virus, however, they appear to be more likely to become so ill that they need ventilation.
According to two other studies, that involves 1,370 people hospitalized. Smokers were 43 percent more likely to see their disease progress to severe than those who had never smoked.
Three studies reported COVID-19 mortality rates, but “there did not appear to be a noticeable difference” between smokers and nonsmokers.
However, the studies “did not explicitly establish never-smoking status,” the authors said. They implied that the patients who died may have smoked in the past, but this was not clearly recorded by a physician.
The authors concluded that there is a lack of evidence that meets a high standard to definitively say whether or not smokers have an increased risk of contracting the coronavirus or having poor results.
The researchers admit that hospitals probably do not record patients’ smoking status correctly, possibly because they are too busy, patients are too sick to respond, or because people lie in their responses.
“Despite these uncertainties, compared to national prevalence estimates, current and past smoking rates recorded in the included studies were generally lower than expected,” the study authors wrote.
Linda Bauld, a professor of public health at the University of Edinburgh, has admitted that “something strange is happening with smoking and the coronavirus.”
She told Good Morning Britain on April 28: ‘We have known for decades that smoking is linked to an increased risk of developing respiratory conditions and that people who smoke have worse outcomes.
“And we still have around seven million smokers in the UK, [the] main preventable cause of death.
“However, my colleagues at UCL … what they found is that surprisingly there are few smokers in those studies who have developed coronavirus.
‘In a French study, four times as many non-smokers contracted the virus and developed COVID-19 compared to smokers.
“There is a possible biological explanation for this.”
Professor Bauld suggested that the way the virus enters the body may be blocked by the effects of nicotine, the addictive compound found in tobacco, a theory popularized by scientists.
The data of the EE. USA They suggest that smokers appear to be less likely to test positive for SARS-CoV-2 compared to those who never smoked. But the researchers noted that smokers were more likely to be tested, possibly because their symptoms are more obvious.
Three studies looked at hospitalization for COVID-19 based on smoking. An analysis of two of these studies provided zero evidence that the current or previous 657 smokers with the virus had an increased risk of ending up in the hospital.
Among 1,370 people hospitalized in two other studies, smokers were 43% more likely to see the progress of their disease than those who had never smoked.
Three studies reported COVID-19 mortality rates, but “there did not appear to be a noticeable difference” between smokers and nonsmokers.
The coronavirus enters cells within the body through structures called ACE-2 receptors, which line the surface of some cells, including the airways and lungs.
The number of ACE-2 receptors someone has is thought to vary by genetics.
Some evidence suggests that they are higher in smokers. This could, in theory, put them at greater risk of contracting the coronavirus.
However, the virus is known to cause lung damage by depleting the number of ACE-2 receptors, so the fact that smoking increases them could reverse the effect and prevent damage to the lungs.
Other studies show that nicotine reduces the action of the ACE-2 receptor, suggesting that smokers are less likely to contract the virus in the first place.
Professor Bauld said: ‘It is plausible that smokers are less likely to develop the condition potentially due to nicotine. Importantly, in that UCL review where smokers developed COVID-19, their results are much worse. ”
A leading infectious disease expert at University College London, Professor Francois Balloux, also previously said that there is “strangely strong” evidence that smoking can be protective.
The first review of the evidence on smoking was conducted in March, when there were very few studies.
But still, the team led by Harvard’s Dr. Constantine Vardavas concluded that smokers face an increased risk of complications, but are less likely to become infected in the first place.
They reviewed five studies, published their findings in the journal Tobacco Induced Diseases, and said that so far the evidence that smoking increases the risk of coronavirus is limited, after finding that only 1.4 percent of hospitalized patients were smokers.
Experts even admitted that the warnings made by health chiefs were based primarily on assumptions, given the known risks of infection from smoking.
The first review of the evidence on smoking took place in March, when there were very few studies: studies from China found that the average proportion of coronavirus patients who were classified as smokers, out of a total of almost 6,000 people, was only 6.5 percent
Dr. Constantine Vardavas concluded that smokers face an increased risk of complications, but are less likely to become infected in the first place: A large study published in the New England Journal of Medicine found that 173 patients had severe symptoms. 16.9 percent of them were current smokers and 5.2 percent had previously smoked. In comparison, of the patients with less severe symptoms, 11.8 percent were current smokers and 1.3 percent were ex-smokers.
Researchers from the Zhongnan Hospital of Wuhan University concluded that only 1.4 percent of the 140 hospitalized patients were smokers.
A study of 41 patients found that none of the 13 patients who needed to be admitted to the ICU were current smokers. In contrast, 11 percent (three) of those who did not need intensive care were smokers.
A study of 140 patients with coronavirus found that among the 58 patients with serious illnesses, 3.4% (two people) were current smokers and 6.9% (four) were ex-smokers. In comparison, of the 82 with milder symptoms, none were current smokers and 3.7 percent (three) were former smokers
What have studies from other countries shown?
La revisión de UCL incluyó 22 estudios realizados en hospitales en China, que mostraron que entre el 3,8 y el 17,6 por ciento de los pacientes con COVID-19 eran fumadores actuales y menos del cinco por ciento eran ex fumadores.
Sin embargo, los datos de 2018 muestran que más de la mitad de la población del país son fumadores actuales (50.5 por ciento de los hombres y 2.1 por ciento de las mujeres).
Y casi uno de cada 10 de los no fumadores en China son exfumadores (8,4 por ciento de los hombres y 0,8 por ciento de las mujeres).
Un estudio separado publicado a principios de abril por científicos en Nueva York y Atenas analizó 13 estudios chinos que habían registrado fumar como condición previa y descubrió que el número de fumadores en toda la muestra de 5.300 pacientes era del 6.5%.
Es un número asombrosamente pequeño en un país donde la mitad de los hombres todavía fuman.
En estudios estadounidenses revisados por UCL, 1.3 a 27.2 por ciento eran fumadores actuales, en contraste con una prevalencia de fumar de 13.8 por ciento en 2018.
Y 2.3 a 30.6 por ciento eran ex fumadores, en comparación con el 20.9 por ciento de los ex fumadores en los estados.
Del mismo modo, los datos publicados en The New England Journal of Medicine de la ciudad de Nueva York, el epicentro de la epidemia en los Estados Unidos, muestran que solo el 5.1 por ciento de los pacientes son fumadores.
En un estudio de Corea del Sur, el 18.5 por ciento eran fumadores actuales, lo que casi coincide con la prevalencia de fumar del 19.3 por ciento en 2016.
En un estudio realizado en Francia, el 7.1 por ciento eran fumadores actuales, el 6.1 por ciento de los cuales fueron hospitalizados. Pero se registran tasas de tabaquismo mucho más altas en la población: 32 por ciento.
Sin embargo, los resultados fueron diferentes para los ex fumadores, de los cuales hay un 31,4 por ciento en Francia. Un 59,1 por ciento mucho más alto de pacientes con COVID-19 eran ex fumadores.
En el estudio internacional con participantes predominantemente del Reino Unido en un entorno hospitalario, el cinco por ciento eran fumadores actuales o anteriores.
Esto se compara con una prevalencia de tabaquismo actual y anterior de 14.4 y 25.8 por ciento en Inglaterra en 2018, “ lo que sugiere una proporción menor de lo esperado de fumadores actuales y anteriores en el estudio incluido ”.
Un estudio realizado por los Centros para el Control de Enfermedades de los Estados Unidos de más de 7,000 personas que dieron positivo para coronavirus, encontró que solo el 1.3 por ciento de ellos eran fumadores, contra el 14 por ciento de todos los estadounidenses que los CDC dicen que fuman.
El estudio también encontró que los fumadores no tenían mayores posibilidades de terminar en el hospital o en una UCI.
Recientemente, el artista de fama mundial David Hockney escribió una carta al Daily Mail diciendo: “ Solía bromear diciendo que ser fumador en Malibu era el equivalente a ser un no fumador en Pasadena. Solían tener muy mala contaminación allí.
‘¿No podría ser que los fumadores hayan desarrollado un sistema inmune a este virus? Con todas estas cifras, estoy empezando a parecerme así “.
El artista británico, que ahora tiene 82 años y vive en Francia, agrega “Hablo en serio” y en el pasado ha revelado que ha fumado durante más de 60 años, pero aún se considera saludable.