I hope whatever wide scale antibody test they do ask if the person smokes as well.
Apart from perhaps coughing, smokers don't "regularly deal" with any of that. Smokers don't have a "sudden loss of sense of smell".
Right. They have a _persistent_ loss of sense of smell. Regaining sense of smell is one of the major changes that ex-smokers notice after quitting. This is very widely known.
> Apart from perhaps coughing, smokers don't "regularly deal" with any of that.
Google "smoker sense of smell" and "smoker sense of taste" and "smoker shortness of breath".
As a Covid-19 therapy oral nicotine would be easy to scale up and distribute. It doesn't take long to turn around a crop of eggplant or tomatoes, and the processing seems simple enough. Effective dosing, safety and the political difficulties of advocating for safe and limited use nicotine seem to be something that would make any public health professional's head spin.
> The researchers will administer nicotine patches to some of the participants for a period of 4 to 5 months, and then carry out a follow-up for 6 to 7 months. Of course, it is still too early to conclude exactly how nicotine interacts with the coronavirus. However, if nicotine is indeed confirmed as a protective factor, NRTs including e-cigarettes could play a pivotal role in controlling this pandemic.
Very curious to see how this goes. I would also love to see information as to why nicotine works this way, and if there are any non-nicotine options that have similar effects? Interesting stuff none the less.
The nicotine patch trial will hopefully shed light on that as well.
In the meantime, it would be nice to see data comparing the hospitalization rates of smokeless tobacco users* vs. smokers and non-tobacco users.
* i.e. Chew, dip, and snus.
I didn’t see something that was a clear consensus, but it seemed like nicotine decidedly modulates the immune system. It seems whatever effects it has might do good things for covid.
Nicotine isn’t evil, and even not particularly addictive when not delivered via burning leaves. (components in smoke change how much enters the brain)
My personal experience is that it is even more addictive. First, with NRT (gum, lozenge) you can use nicotine much more frequently - e.g. even going to bed with lozenge in your mouth. Second, you can easily increase your dosage. 2mg piece of gum not doing it for you? Pop in a few more or move up to 4mg. Switch to mini-lozenge and you can suck on say 5 * 4mg lozenges at one time.
By that time, I'd expect widespread vaccinations particularly among older and at-risk people. Is this going to be anything more than a curiosity at that time? Maybe something to keep on the shelf for the next pandemic? Or a hedge in case the vaccine immunity is short-lived?
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9...
This paper points out that patients on infliximab (trade name Remicade: immune system modulator used by people with chronic autoimmune diseases, particularly IBD and rheumatoid arthritis) don't seem to be at elevated risk of severe COVID – which is surprising because these are powerful immune system suppressants.
But any pathologist would have known immediately about the risks of inflammation and that being the auto-response. It would have been evaluated is what I'm assuming.
I have colitis which similarly causes artificial immune response in the digestive tract and they used steroids to help reduce the inflammation which was causing other serious problems in my body. But only during a very serious episode. Other lighter approaches are available to keep it under control.
Note: I'm not a medical expert at all and could be talking out of my ass. Just basing this on personal experience and some personal reading into pathology.
Seriously, ask a doctor, but these might give you starting points for the discussion:
This is a very high-value part of pharma research, because inflammation is at the root of a lot of lifelong chronic disease and is basically only manageable rather than curable. But because inflammation is a systemic response, all drugs which modulate the immune system are serious business.
For short-term use: corticosteroids (eg prednisone), and I think best-current acute Covid pneumonia protocols involve quite a lot of these, particularly dexamethasone (https://www.covid19treatmentguidelines.nih.gov/immune-based-...). Corticosteroids are extremely powerful drugs. Some of them are used topically for acute local inflammation (hydrocortisone is the best known of those and is available OTC from pharmacists for rashes), but that's basically the only context you're likely to encounter them taken as lightly as, eg, aspirin or acetaminophen.
Long-term use; there are some small molecules, eg methotrexate, which modulate the immune system – hydroxychloroquine is one of these used in lupus treatment, but there is plenty of evidence that it harms rather than helps in the Covid case.
That leaves you some of the second-line treatments used for chronic immune system diseases like rheumatoid arthritis, Crohn's disease, and ulcerative colitis, and there the Lancet paper I linked up-thread suggests these may have some utility/protective value against Covid, found by studying correlations in patients undergoing these therapies for pre-existing conditions.
But: these are not easy options. They're "biologics" (big proteins). You've had or know people who've had some of these. The ones you've probably encountered are vaccines and insulin, but the big growth area has been monoclonal antibodies. Some of these can directly modulate specific signalling pathways, particularly inflammation pathways, which is why they are effective against the diseases of systemic inflammation above. But: these drugs are extremely expensive to develop (so the US prices are ungodly high), difficult to transport, store and deliver - often requiring IV infusion (I think Humira has a self-injectable formulation, but none of them are oral medications) - and have systemic side effects basically by design.
Two new monoclonal antibody therapies of this class have US EUAs (emergency use authorizations) for Covid; https://www.fiercepharma.com/pharma/regeneron-following-lill.... One of them (the Regeneron one) is the one Donald Trump had.
Not to be macabre, but could it potentially be that more smokers die before reaching the older age range of most COVID hospitalizations?
> The researchers had estimated the rates of daily current smokers among COVID-19-infected patients and compared them to the rates of daily current smokers within the general French population, after controlling the data for sex and age.
So, assuming they correctly controlled for age, then no, it’s not “anti-survivorship” bias. (“Casualty bias”?)
I think you're the first person I've encountered who desires to use nicotine patches indefinitely. Isn't the idea usually to gradually wean off of them instead of just continuing to use them forever?
Myself, I vaporise moderate amounts of nicotine. It is not part of my identity, it just got me off cigarettes. I have no plans to reduce or discontinue my usage at this time. A stable mental state and staying off cigarettes is more important right now.
Abstinence is a noble goal, but it is not always practical. In those cases, reducing the harm is desirable.
Wow. Hooking participants on nicotine for research seems like an extreme measure to research this. I know that nicotine-patches cannot be compared to cigarette-hits in addictiveness. But still, I take it as given that a few participants will start to smoke tobacco after this.
Since the effect promises to be really big though, I'll accept the argument that it's worth to study it. I just wonder how we'll deal with a positive result. Will the at-risk population actually be advised to take nicotine preventatively?
I can't imagine anyone is too eager to do that study. If I was covid health care worker, I'd probably be on a low dose of amphetamines right now. Purely as prophylaxis, of course.
