cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2020-2604cardiovascular-2604Research ArticleОБЗОРЫREVIEWSКурение табака и COVID-19: старый враг в новом обличии. Обзор текущей научной литературыTobacco smoking and COVID-19: an old enemy in a new guise. Review of current publicationshttps://orcid.org/0000-0003-4018-8645ГамбарянМ. Г.GambaryanM. G.

Гамбарян Маринэ Генриевна — кандидат медицинских наук, руководитель Отдела центр профилактики и контроля потребления табака

Москва

mgambar@mgnicpm.comhttps://orcid.org/0000-0002-4453-8430ДрапкинаО. М.DrapkinaO. M.

Драпкина Оксана Михайловна — доктор медицинских наук, профессор, член-корреспондент РАН, директор

Москва

odrapkina@gnicpm.ruФГБУ “Национальный медицинский исследовательский центр терапии и профилактической медицины” Минздрава РоссииРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian Federation20200206202019326042604Copyright © Гамбарян М.Г., Драпкина О.М., 20202020Гамбарян М.Г., Драпкина О.М.Gambaryan M.G., Drapkina O.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2604

В работе обобщены имеющиеся на настоящий момент научные факты, посвященные взаимосвязям курения табака, потребления электронных сигарет и новой коронавирусной инфекции COVID-19 (COronaVIrus Disease-19). Проанализированы социально-демографические особенности пациентов с COVID-19 и сопутствующие заболевания, которые указывают на возможную связь между курением и развитием заболевания. Показаны результаты последних крупных метаанализов, свидетельствующих о повышенном риске прогрессирования, развития тяжелых осложнений и неблагоприятных исходов COVID-19 у курильщиков, а также у пациентов с хронической обструктивной болезнью легких, для которой курение является ведущим фактором риска. Предполагается, что курение табака и потребление электронных сигарет вызывает дозозависимую активацию рецептора ангиотензинпревращающего фермента-2 — рецептора проникновения в клетку вируса, что может объяснить более высокий риск развития тяжелого COVID-19 у курильщиков и вейперов. Отмечается некоторая противоречивость в интерпретации данных, основанная на наблюдениях относительно низкой распространенности курения среди пациентов с COVID-19 по сравнению с таковой в популяции, которая, в частности, была связана с некачественным сбором информации о курении, но, тем не менее, послужила основанием для гипотезы о протективном воздействии никотина в отношении COVID-19. Необходимо дальнейшее изучение вопроса, с большим числом независимых исследований, однако пока очевидно, что курение связано с прогрессированием и неблагоприятным исходом COVID-19.

The review summarizes the current data on the relationship of tobacco smoking, e-cigarette use and the novel coronavirus infection COVID-19. The socio-demographic characteristics of patients with COVID-19 and associated diseases, which indicate a possible relationship between smoking and the disease, are analyzed. Recent large meta-analyzes demonstrating the increased risk of progression, the development of severe complications and adverse outcomes of COVID-19 in smokers, as well as in patients with chronic obstructive pulmonary disease, for which smoking is a leading risk factor, are shown. It is believed that tobacco smoking and e-cigarette use causes dose-dependent activation of the angiotensin-converting enzyme-2 receptor, by which virus penetrates to host cell. This may explain the higher risk of complicated COVID-19 in smokers and vapers. There is conflicting data because some studies showed some relatively low smoking prevalence among patients with COVID-19 compared with general population. This, in particular, was associated with poor-quality data collection about smoking, but, nevertheless, was the basis for hypotheses about the protective effect of nicotine against COVID-19. This issue needs further large independent studies, but it is clear so far that smoking is associated with the progression and adverse outcomes of COVID-19.

курениеCOVID-19коронавирусная инфекциякурение табакапотребление электронных сигаретвейпыsmokingCOVID-19coronavirus infectiontobacco smokinge-cigarette usevapesReferencesWorld Health Organization. Coronavirus disease (COVID-19) outbreak https://www.who.int.World Health Organization. Coronavirus disease (COVID-19) outbreak https://www.who.int.Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239- 42. doi:10.1001/jama.2020.2648.Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239- 42. doi:10.1001/jama.2020.2648.Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi:10.1056/NEJMoa2002032.Guan WJ, Ni ZY, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi:10.1056/NEJMoa2002032.Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5.Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. doi:10.1016/S0140-6736(20)30183-5.Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020. doi:10.1111/all.14238.Zhang JJ, Dong X, Cao YY, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. 2020. doi:10.1111/all.14238.Choi KW, Chau TN, Tsang O, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Inter Med. 2003;139:715-23. doi:10.7326/0003-4819-139-9-200311040-00005.Choi KW, Chau TN, Tsang O, et al. Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Inter Med. 2003;139:715-23. doi:10.7326/0003-4819-139-9-200311040-00005.Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med. 2020;8(4):e20. doi:10.1016/S2213-2600(20)30117-X.Cai H. Sex difference and smoking predisposition in patients with COVID-19. Lancet Respir Med. 2020;8(4):e20. doi:10.1016/S2213-2600(20)30117-X.Cattaruzza MS, Zagà V, Gallus S, et al. Tobacco smoking and COVID19 pandemic: old and new issues. A summary of the evidence from the scientific literature Acta Biomed. 2020;91(2):106-12. doi:10.23750/abm.v91i2.9624.Cattaruzza MS, Zagà V, Gallus S, et al. Tobacco smoking and COVID19 pandemic: old and new issues. A summary of the evidence from the scientific literature Acta Biomed. 2020;91(2):106-12. doi:10.23750/abm.v91i2.9624.The OpenSAFELY Collaborative, Williamson E, Walker AJ, Bhaskaran KJ, et al. OpenSAFELY: factors associated with COVID19-related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv preprint doi:10.1101/2020.05.06.20092999.The OpenSAFELY Collaborative, Williamson E, Walker AJ, Bhaskaran KJ, et al. OpenSAFELY: factors associated with COVID19-related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv preprint doi:10.1101/2020.05.06.20092999.Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2020;8(1):e35. PMCID: PMC7096724.Emami A, Javanmardi F, Pirbonyeh N, Akbari A. Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2020;8(1):e35. PMCID: PMC7096724.Lawrence H, Hunter A, Murray R, et al. Cigarette smoking and the occurrence of influenza–Systematic review. J Infect. 2019;79(5):401-6. doi:10.1016/j.jinf.2019.08.014.Lawrence H, Hunter A, Murray R, et al. Cigarette smoking and the occurrence of influenza–Systematic review. J Infect. 2019;79(5):401-6. doi:10.1016/j.jinf.2019.08.014.Liu W, Tao ZW, Lei W, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J. 2020;133(9):1032-8. doi:10.1097/CM9.0000000000000775.Liu W, Tao ZW, Lei W, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. Chin Med J. 2020;133(9):1032-8. doi:10.1097/CM9.0000000000000775.Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis. 2020;18:20. doi:10.18332/tid/119324.Vardavas CI, Nikitara K. COVID-19 and smoking: A systematic review of the evidence. Tob Induc Dis. 2020;18:20. doi:10.18332/tid/119324.Lippi G, Henry BM. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Eur J Intern Med. 2020;S0953-6205(20)30110-2. doi:10.1016/j.ejim.2020.03.014.Lippi G, Henry BM. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Eur J Intern Med. 2020;S0953-6205(20)30110-2. doi:10.1016/j.ejim.2020.03.014.Alqahtani J, Oyelade T, Aldhahir A, et al. Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. PLOS ONE. 2020;15(5):e0233147. doi:10.1371/journal.pone.0233147.Alqahtani J, Oyelade T, Aldhahir A, et al. Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis. PLOS ONE. 2020;15(5):e0233147. doi:10.1371/journal.pone.0233147.Patanavanich R, Glantz S. Smoking Is Associated With COVID-19 Progression: A Meta-analysis. Nicotine & Tobacco Research. 2020;ntaa082, doi:10.1093/ntr/ntaa082.Patanavanich R, Glantz S. Smoking Is Associated With COVID-19 Progression: A Meta-analysis. Nicotine & Tobacco Research. 2020;ntaa082, doi:10.1093/ntr/ntaa082.Mehra MR, Desai SS, Kuy S, Henry TD, Patel AN. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. 2020. doi:10.1056/NEJMoa2007621.Mehra MR, Desai SS, Kuy S, Henry TD, Patel AN. Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. 2020. doi:10.1056/NEJMoa2007621.Farsalinos K, Angelopoulou A, Alexandris N, Poulas K. COVID19 and the nicotinic cholinergic system. Eur Respir J. 2020. doi:10.1183/13993003.01589-2020.Farsalinos K, Angelopoulou A, Alexandris N, Poulas K. COVID19 and the nicotinic cholinergic system. Eur Respir J. 2020. doi:10.1183/13993003.01589-2020.Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review. (version 3) Qeios. 2020; ID: UJR2AW.4 doi:10.32388/UJR2AW.4.Simons D, Shahab L, Brown J, Perski O. The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review. (version 3) Qeios. 2020; ID: UJR2AW.4 doi:10.32388/UJR2AW.4.Gilmore А. Review of: Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19. Qeios. 2020; ID: 37F3UD Open Access CC BY Cite. doi:10.32388/37F3UD.Gilmore А. Review of: Low incidence of daily active tobacco smoking in patients with symptomatic COVID-19. Qeios. 2020; ID: 37F3UD Open Access CC BY Cite. doi:10.32388/37F3UD.World Health Organization. Global Health Observatory (GHO) Data. https://www.who.int/gho/tobacco/use/en/World Health Organization. Global Health Observatory (GHO) Data. https://www.who.int/gho/tobacco/use/en/Oakes JM, Fuchs RM, Gardner JD, et al. Nicotine and the reninangiotensin system. Am J Physiol Regul Integr Comp Physiol. 2018;315(5):R895-R906.5. doi:10.1152/ajpregu.00099.2018.Oakes JM, Fuchs RM, Gardner JD, et al. Nicotine and the reninangiotensin system. Am J Physiol Regul Integr Comp Physiol. 2018;315(5):R895-R906.5. doi:10.1152/ajpregu.00099.2018.Wang J, Luo Q, Chen R, et al. Susceptibility analysis of COVID19 in smokers based on ACE2. Prereprints. 2020;2020030078. doi:10.20944/preprints202003.0078.v.Wang J, Luo Q, Chen R, et al. Susceptibility analysis of COVID19 in smokers based on ACE2. Prereprints. 2020;2020030078. doi:10.20944/preprints202003.0078.v.Brake SJ, Barnsley K Lu W, et al. Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19). J Clin Med. 2020;9(3):841. doi:10.3390/jcm9030841.Brake SJ, Barnsley K Lu W, et al. Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19). J Clin Med. 2020;9(3):841. doi:10.3390/jcm9030841.Smith JC, Sheltzer JM. Cigarette smoke triggers the expansion of a subpopulation of respiratory epithe- lial cells that express the SARS-CoV-2 receptor ACE2. bioRxiv. 2020. doi:10.1101/2020.03.28.01367.Smith JC, Sheltzer JM. Cigarette smoke triggers the expansion of a subpopulation of respiratory epithe- lial cells that express the SARS-CoV-2 receptor ACE2. bioRxiv. 2020. doi:10.1101/2020.03.28.01367.Leung J M, Yang Ch X, Tam A, et al. ACE-2 Expression in the Small Airway Epithelia of Smokers and COPD Patients: Implications for COVID-19. Eur Respir J. 2020; 55(5):200068. doi:10.1183/13993003.00688-2020.Leung J M, Yang Ch X, Tam A, et al. ACE-2 Expression in the Small Airway Epithelia of Smokers and COPD Patients: Implications for COVID-19. Eur Respir J. 2020; 55(5):200068. doi:10.1183/13993003.00688-2020.Monteil V, Kwon H, Prado P, et al. Inhibition of SARS-CoV-2 Infections in Engineered Human Tissues Using Clinical-Grade Soluble Human ACE2. Cell. 2020. doi:10.1016/j.cell.2020.04.004.Monteil V, Kwon H, Prado P, et al. Inhibition of SARS-CoV-2 Infections in Engineered Human Tissues Using Clinical-Grade Soluble Human ACE2. Cell. 2020. doi:10.1016/j.cell.2020.04.004.Farsalinos K, Niaura R, Le Houezec J, et al. Editorial: Nicotine and SARS-CoV-2: COVID-19 may be a disease of the nicotinic cholinergic system, Toxicol Rep. 2020;7:658-63. doi:10.1016/j.toxrep.2020.04.012.Farsalinos K, Niaura R, Le Houezec J, et al. Editorial: Nicotine and SARS-CoV-2: COVID-19 may be a disease of the nicotinic cholinergic system, Toxicol Rep. 2020;7:658-63. doi:10.1016/j.toxrep.2020.04.012.Changeux JP, Amoura Z, Rey F, Miyara M. A nicotinic hypothesis for COVID-19 with preventive and therapeutic implications. Qeios. 2020; doi:10.32388/FXGQSB.2.Changeux JP, Amoura Z, Rey F, Miyara M. A nicotinic hypothesis for COVID-19 with preventive and therapeutic implications. Qeios. 2020; doi:10.32388/FXGQSB.2.Miyashita L, Suri R, Dearing E, et al. E-cigarette vapour enhances pneumococcal adherence to airway epithelial cells. Eur Respir J. 2018;51(2): 1701592. doi:10.1183/13993003.01592-2017.Miyashita L, Suri R, Dearing E, et al. E-cigarette vapour enhances pneumococcal adherence to airway epithelial cells. Eur Respir J. 2018;51(2): 1701592. doi:10.1183/13993003.01592-2017.Martin EM, Clapp PW, Rebuli ME, et al. E-cigarette use results in suppression of immune and inflammatory-response genes in nasal epithelial cells similar to cigarette smoke. Am J Physiol Lung Cell Mol Physiol. 2016;311(1):L135-44. doi:10.1152/ajplung.00170.2016.Martin EM, Clapp PW, Rebuli ME, et al. E-cigarette use results in suppression of immune and inflammatory-response genes in nasal epithelial cells similar to cigarette smoke. Am J Physiol Lung Cell Mol Physiol. 2016;311(1):L135-44. doi:10.1152/ajplung.00170.2016.McAlinden KD, Sohal SS, Sharma P. There can be smoke without fire: warranted caution in promoting electronic cigarettes and heat not burn devices as a safer alternative to cigarette smoking. ERJ Open Research. 2019;5:00114-2019. doi:10.1183/23120541.00114-2019.McAlinden KD, Sohal SS, Sharma P. There can be smoke without fire: warranted caution in promoting electronic cigarettes and heat not burn devices as a safer alternative to cigarette smoking. ERJ Open Research. 2019;5:00114-2019. doi:10.1183/23120541.00114-2019.Werner AK, Koumans EH, Chatham-Stephens K, et al. Hospitalizations and Deaths Associated with EVALI. N Engl J Med. 2020;382(17):1589-98. doi:10.1056/NEJMoa1915314.Werner AK, Koumans EH, Chatham-Stephens K, et al. Hospitalizations and Deaths Associated with EVALI. N Engl J Med. 2020;382(17):1589-98. doi:10.1056/NEJMoa1915314.Bao W, Xu G, Lu J, et al. Changes in Electronic Cigarette Use Among Adults in the United States, 2014-2016. JAMA. 2018;319(19):2039-41. doi:10.1001/jama.2018.4658.Bao W, Xu G, Lu J, et al. Changes in Electronic Cigarette Use Among Adults in the United States, 2014-2016. JAMA. 2018;319(19):2039-41. doi:10.1001/jama.2018.4658.Информационная записка: COVID-19 и НИЗ-ВОЗ, 23 марта 2020г. https://www.who.int/who-documents-detail/covid-19-and-ncds.Information note on COVID-19 and NCDs-WHO, 23 March 2020. (In Russ.) https://www.who.int/who-documents-detail/covid-19-and-ncds.

The authors declare that there are no conflicts of interest present.