Nicotine treatment and smoking cessation in the era of COVID-19 pandemic: an interesting alliance

Abstract

In the era of this pandemic, the role of medicinal nicotine in the prevention and treatment of #COVID19 disease should be evaluated in placebo-controlled trials, while smoking cessation should be further promoted as a general public health measure https://bit.ly/3fpsBdq.

FIGURE 1

The complex interaction between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), nicotine and the renin-angiotensin-aldosterone system. SARS-CoV-2 binds to the its functional receptor on alveolar epithelial cells, that is angiotensin-converting enzyme (ACE)2. This binding results in viral endocytosis and replication, along with ACE2 downregulation. Nicotine might interact with RAAS in multiple ways: 1) by upregulating angiotensin II type I receptor, and thus by inducing angiotensin II deleterious effects; and 2) by downregulating ACE2, and thus reducing the number of potential virus entries or by upregulating ACE2, via nicotinic acetylcholine receptor α7 subunit (α7-nAChR). The latter signalling pathway may also result in the downregulation of cytokine production by the macrophages [2, 4]. AT1R: angiotensin II type I receptor; TNF: tumour necrosis factor; IL: interleukin.