Nicotine as a Potential Therapy for COVID?

[McCamy Taylor]

No one is suggesting that people take up smoking to fight COVID. Cigarettes are full of nasty stuff that weakens your lungs. However, some researchers have concluded that

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192087/

we noticed that most of the clinical characteristics of severe COVID-19 could be explained by dysregulation of the cholinergic anti-inflammatory system.

I have been writing about this lately (see my old journals for more). My theory is that COVID affects the various cranial nerves including the vagus which in turn weakens the body's natural cholinergic system.

What readily available medications can augment a weakened cholinergic system? One is nicotine

The authors of this editorial write:

Once someone is infected with SARS-CoV-2, the immune system is mobilized. As the virus replicates, cell and viral debris or virions may interact with the nAChRs blocking the action of the cholinergic anti-inflammatory pathway. If the initial immune response is not enough to combat the viral invasion at an early stage, the extensive and prolonged replication of the virus will eventually block a large part the cholinergic anti-inflammatory pathway seriously compromising its ability to control and regulate the immune response. The uncontrolled action of pro-inflammatory cytokines will result in the development of cytokine storm, with acute lung injury leading to ARDS, coagulation disturbances and multiorgan failure. Based on this hypothesis, COVID-19 appears to eventually become a disease of the nicotinic cholinergic system. Nicotine could maintain or restore the function of the cholinergic anti-inflammatory system and thus control the release and activity of pro-inflammatory cytokines. This could prevent or suppress the cytokine storm. This hypothesis needs to be examined in the laboratory and the clinical setting.

[napi21]

1. I read several published articles about nicotine and Covid19. Not being trained in medicine, most

of the articles are way beyond my understanding. I do however find it very humorous that every scientist who says it shows promise and should be studied, but also feels compelled to say "we are not advocating that everyone take up smoking." I understand that too, but wouldn't it be funny if the smoking habit actually had a positive note? Yes, as a smoker I find it quite funny.

[tazkcmo]

8. Me too.

I now refer to my smoking as vaccinating.

[Backseat Driver]

2. What do you know about SuPAR(s) involvement in this pathway?

I found this an interesting substance having to do with severity of illness.

Does it fit into your hypothesis of controlling cytokine storms or nicotine as a pharmaceutical therapy?

I'm thinking we're missing something about viral load from initial contact through replication - perhaps "timing is everything" to prevent advanced severity???

https://en.wikipedia.org/wiki/SuPAR

[Journeyman]

3. Smoking does help with social distancing. I know I give smokers a wide berth . . .

[NurseJackie]

9. Even when they're NOT smoking.

Ugh.

[Jedi Guy]

10. Yeah, I'm amazed my mother was able to hug me back when I was a smoker.

Especially since she's an ex-smoker herself. It wasn't until after I quit smoking (and took up vaping) that I realized just how awful cigarettes really smell, and how awful they make smokers smell. The strength of a mother's love, I guess!

[NurseJackie]

11. I'm "retroactively ashamed" of how awful I must have smelled to others.

And I'm horrified that I'd smoke in the house... with kids in the house. (We just never thought about things like that.)

And when I look at old movies... EVERYONE smokes. I watch Perry Mason on "CBS All Access" streaming, and I wonder if it was sponsored by some cigarette company. And then there are the old movies and TV shows where people are smoking on an airplane... not a care in the world, no worries, and it's perfectly normal (for the time).

With the current price of cigarettes in Maryland... at a carton a week (my old habit)... that's over $3380.00 a year that could be spent on something else.

[Jedi Guy]

12. Same here, with the retroactive shame.

I smoked in my apartment, I smoked in my car. My clothing reeked of it. Hell, I have a lot of RPG books that are out of print and extremely hard to find... but even if I wanted to sell them, I probably couldn't. They still smell like smoke.

And yeah, what really did it for me and my wife was the cost. Between the two of us, we were literally burning about $25 per day, so about $9000 a year. When we quit smoking and switched to vaping, we were astounded at how much "extra" money we suddenly had. We joke that when we were smoking, we were playing life on hard mode.

I'm glad you were able to kick the habit!

[roamer65]

4. If CV messes around with the vagus nerve, that explains the GI symptoms.

The vagus nerve serves the GI tract.

Sounds like nicotine patches could be a treatment, if this article is accurate.

[CentralMass]

5. According to WHO smoking kills more than 8 million people a year.

https://www.who.int/news-room/fact-sheets/detail/tobacco
"Key facts
Tobacco kills up to half of its users.
Tobacco kills more than 8 million people each year. More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke."

[DrToast]

15. And?

[USALiberal]

20. You can figure it out on your own. nt

[Mariana]

16. Fortunately, there are several ways to get nicotine

that don't involve smoking.

[Baclava]

17. Or tobacco, vapers get the pure juice of nicotine with none of the tars from that filthy plant

Open up hospitals, bars and restaurants to vaping immediately! no secondhand smoke either

[JustABozoOnThisBus]

6. The hypothesis could cause a shortage of nicotine patches.

I haven't smoked in many years, but if my health could be ensured by a good cigar ...

[planetc]

7. What does "the clinical setting" mean?

"In the laboratory" means researchers meddling with mice, but what does a clinical setting mean? The authors seem to be recommending we try it out on patients?

[Wounded Bear]

13. Basically, yes...clinical trals involving people...nt

[MiniMe]

18. And I just quit smoking in November

Sigh. But I'm not going back to it.

[McCamy Taylor]

19. From 2004, Medical uses of nicotine, a review

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC526783/

[Buckeye_Democrat]

21. I said to a smoking coworker soon after the virus...

... reached the USA, and after he said that he'd probably be among the first to die from a lung infection, "Wouldn't it be funny if the nicotine helped protect you in some way?"

[McCamy Taylor]

22. 1985 study, nicotine cuts down apneic spells in sleep apnea

https://www.ncbi.nlm.nih.gov/pubmed/3965253

Reduced upper airway muscle activity may contribute to the occurrence of obstructive apneas during sleep. There is no uniformly successful treatment of these apneas, and it is possible that agents which increase upper airway muscle activity could reduce the occurrence of obstruction during sleep. Nicotine, a known stimulant of breathing, also increases the activity of muscles which dilate the upper airway proportionally more than it does ventilation. Hence, we evaluated the effect of nicotine on apneas during the first two hours of sleep in eight patients with sleep apnea syndrome. It was concluded that nicotine reduces apneas during the early hours of sleep, and this effect may be caused by its stimulating action on upper airway muscles.

Unfortunately, since nicotine is like aspirin (not patented) it is very unlikely that any drug company will invest money in studies of its efficacy as a medicine. They are more likely to tweak it, make a new molecule that can then be patented and then do studies. At least, that is what I would have said before COVID.

Opium is one of nature's wonder drugs. So is willow bark (aspirin). So is foxglove (digitalis). Maybe the first Americans were on to something when they used tobacco in an unadulterated form for medicinal purposes.