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Smoking may increase the risks of COVID-19
Spreading to over 110 countries, coronavirus disease 2019 (COVID-19) has aroused panic across the globe. The World Health Organization (WHO) raised the global risk of COVID-19 to “very high” on 28 February 2020 and declared COVID-19 as a pandemic on 11 March 2020. While limited is known about the novel coronavirus, rumors are going around. WHO has already clarified that the fake statement “smoking could help prevent COVID-19” is false and misleading. Scientific evidence has also emerged to show that smoking may increase the risk of the infection.

Researchers from China and the United States examined the background characteristics of the first 8,866 COVID-19 cases in China. Consistent with the cases of Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), men and elderly are more likely to be infected, and suffer from severe pneumonia and die upon infection. Given the higher susceptibility to respiratory illness in smokers and the much higher smoking prevalence in Chinese males than females (52.1% vs 2.7%, WHO Report on the Global Tobacco Epidemic 2019), experts suspect that smokers may have higher risk of COVID-19.

Latest laboratory studies have shed light on the potential links between smoking and COVID-19. Angiotensin-converting enzyme 2 (ACE2) is a receptor of the novel coronavirus. Although whether it is the only or major receptor of the virus is still unknown, it is noteworthy that significantly higher ACE2 gene expression was observed in lung tissue of smokers compared with non-smokers. Researchers also found active ACE2 expression at different locations of the lungs in smokers and non-smokers. These findings suggest that smokers may have higher susceptibility to COVID-19 and infection paths different from non-smokers.

While further investigations on the links between smoking and COVID-19 are necessary, everyone in the society should do their utmost to minimize their risk of COVID-19. In addition to maintaining personal hygiene, COSH strongly advises the public not to initiate smoking and go smoke-free in order to reduce the susceptibility to respiratory illness.

Source: Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China (2020); Tobacco-Use Disparity in Gene Expression of ACE2, the Receptor of 2019-nCov (2020); Bulk and Single-Cell Transcriptomics Identify Tobacco-Use Disparity in Lung Gene Expression of ACE2, the Receptor of 2019-nCov (2020)
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