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Review
. 2021 Jan:176:106233.
doi: 10.1016/j.rmed.2020.106233. Epub 2020 Nov 19.

Tobacco use as a well-recognized cause of severe COVID-19 manifestations

Alpana Kumar Gupta  1 , Suzanne Tanya Nethan  2 , Ravi Mehrotra  3
Affiliations
Review

Tobacco use as a well-recognized cause of severe COVID-19 manifestations

Alpana Kumar Gupta et al. Respir Med. 2021 Jan.

Abstract

Introduction: The Coronavirus disease (COVID-19) infection is caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) primarily affecting the lungs. All tobacco-related illnesses including asthma, chronic obstructive pulmonary disease (COPD), and coronary artery disease are known to reduce the lung capacity and impair the immune system of the body and can greatly influence the ability to fight the novel coronavirus. The purpose of this state-of-the-art literature review is to summarize the evidence of the association of tobacco use with the severity of the COVID-19 manifestations.

Method: Articles describing the association of tobacco use with the severity of COVID-19 manifestations were searched on PubMed, MEDLINE, and Google. This review covers the relevant studies on the subject published from January 1, 2020 to September 10, 2020.

Results: Tobacco use in all forms, whether smoking or chewing, is significantly associated with severe COVID-19 outcomes. Pre-existing comorbidities in tobacco users such as cardiovascular diseases, diabetes, respiratory diseases and hypertension were found to further aggravate the disease manifestations making the treatment of such COVID-19 patients more challenging due to their rapid clinical deterioration.

Conclusions: Current review indicates that nicotine exposure is linked to cardiopulmonary vulnerability to COVID-19 and tobacco use can be a potential risk factor for not only getting the viral infection but also its severe manifestations. The current pandemic provides a teachable moment to break the cycle of nicotine addiction and accelerate national tobacco control programs to achieve a tobacco-free world.

Keywords: ACE-2; COVID-19; Cessation; Severity; Tobacco use.

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Conflict of interest statement

Authors Dr. Alpana K Gupta, Dr. Suzanne T Nethan and Dr. Ravi Mehrotra hereby state that they have no conflict of Interest regarding the submitted manuscript entitled " Tobacco Use: A Potential Risk Factor for Severe COVID-19 Manifestations".

Figures

Fig. 1
Fig. 1
Search strategy flow-chart.
See this image and copyright information in PMC

References

    1. WHO Tobacco. 2020. https://www.who.int/news-room/fact-sheets/detail/tobacco accessed.
    1. Sinha D.N., Gupta P.C., Kumar A., Bhartiya D., Agarwal N., Sharma S., Singh H., Parascandola M., Mehrotra R. The poorest of poor suffer the greatest burden from smokeless tobacco use: a study from 140 countries. Nicotine Tob. Res. 2017 doi: 10.1093/ntr/ntx276. - DOI - PMC - PubMed
    1. Word Health Organization . WHO Libr. Cat. Data; 2012. Mortality Attributable of Tobacco: WHO Global Report.
    1. Berg C.J., Fong G.T., Thrasher J.F., Cohen J.E., Maziak W., Lando H., Drope J., Mejia R., Barnoya J., Nakkash R., Salloum R.G., Parascandola M. The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US, Addict. Beyond Behav. 2018;87:162–168. doi: 10.1016/j.addbeh.2018.07.012. - DOI - PMC - PubMed
    1. Bhisey R.A., Ra B., Bhisey R.A. Chemistry and toxicology of smokeless tobacco. Indian J. Canc. 2012;49:364–372. doi: 10.4103/0019-509X.107735. - DOI - PubMed