Nicotine patches trial awaits approval after French study finds nicotine may be COVID-19 preventative

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French researchers are planning to test nicotine patches on coronavirus patients and frontline health workers after a study suggested smokers may be much less at risk of contracting the virus. The Guardian reports that a study at Hôpitaux de Paris and Pasteur Institute, Paris suggests a substance in tobacco – possibly nicotine – may be stopping patients who smoke from catching COVID-19. Clinical trials of nicotine patches are awaiting the approval of the country’s health authorities.

However, the researchers insisted they were not encouraging the population to take up smoking, which carries other potentially fatal health risks and kills 50% of those who take it up. While nicotine may protect those from the virus, smokers who have caught it often develop more serious symptoms because of the toxic effect of tobacco smoke on the lungs, they say.

The renowned French neurobiologist Jean-Pierre Changeux, who reviewed the study, suggested the nicotine might stop the virus from reaching cells in the body preventing its spread. Nicotine may also lessen the overreaction of the body’s immune system that has been found in the most severe cases of COVID-19 infection.

The report says the findings are to be verified in a clinical study in which frontline health workers, hospital patients with the COVID-19 virus and those in intensive care will be given nicotine patches.

The results confirm a Chinese study published at the end of March in the New England Journal of Medicine that suggested only 12.6% of 1,000 people infected with the virus were smokers while the number of smokers in China is around 28%.

Abstract
SARS-CoV-2 epidemics raises a considerable issue of public health at the planetary scale. There is a pressing urgency to find treatments based upon currently available scientific knowledge. Therefore, we tentatively propose a hypothesis which hopefully might ultimately help saving lives. Based on the current scientific literature and on new epidemiological data which reveal that current smoking status appears to be a protective factor against the infection by SARS-CoV-2 [1], we hypothesize that the nicotinic acetylcholine receptor (nAChR) plays a key role in the pathophysiology of Covid-19 infection and might represent a target for the prevention and control of Covid-19 infection.

Authors
Jean-Pierre Changeux, Zahir Amoura, Felix Rey, Makoto Miyara

Abstract 2
Background: Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients.
Methods: We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death.

Results: The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission.
Conclusions: During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings.

Authors
Wei-jie Guan, Zheng-yi Ni, Yu Hu, Wen-hua Liang, Chun-quan Ou, Jian-xing He, Lei Liu, Hong Shan, Chun-liang Lei, David SC Hui, Bin Du, Lan-juan Li, China Medical Treatment Expert Group for COVID-19

Full report in The Guardian

Qeios abstract

The New England Journal o Medicine abstract

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