❓ارتباط کووید-۱۹ با نیکوتین و سیگار؛
آیا بهطور علمی چیزی اثبات شده؟
@HealthNotes#پاسخ از
⭐️ #دکتر_پریا_بهارونددارای بورد تخصصی داروسازی بالینی از دانشگاه علوم پزشکی تهران
🔴 با استناد به مقاله مروري با عنوان
(COVID-19 and smoking: A systematic review of the evidence)
كه در تاريخ ۱۹ مارس ۲۰۲۰ منتشر شده است، هرچند دادهها ناكافي است و توجه به اثر همزماني ساير ريسك فاكتورها صورت نگرفته است، مصرف سيگار تأثير منفي بر روند پروگرس بيماري و سرنوشت مبتلایان کووید-۱۹ داشته است.
همچنين با استناد مقاله منتشر شده در وبسایت سازمان بهداشت حهانی، با عنوان
Smoking and COVID-19))،
در ۳۰ ژوئن ۲۰۲۰، بر اساس بررسيهاي صورت گرفته، مصرف سيگار با شدت بيماري و مرگ در بيماران بستري کووید-۱۹ مرتبط بوده است. اگرچه شواهدي مبني بر بررسي اثر سيگار به عنوان ريسك فاكتور در احتمال ميزان بستري شدن افراد مبتلا به کووید-۱۹ و يا ريسك ابتلا به این بيماري بر اساس دادههاي فعلي يافت نشده است.
⭐️ #دکتر_پریا_بهارونددارای بورد تخصصی داروسازی بالینی از دانشگاه علوم پزشکی تهران
@GreatPharos |
@HealthNotesIt is extremely difficult to synthesise evidence on nicotine and COVID-19 as much of the literature is inconsistent.
Below we highlight pathways/hypothetical mechanisms through which at least one paper has speculated nicotine might impact SARS-Cov-2:
• Current and past tobacco smoking are associated with changes in ACE2 receptor expression
• Nicotine up-regulates the ACE/angiotensin (ANG)-II/ANG II type 1 receptor axis, and down-regulates the compensatory ACE2/ANG-(1–7)/Mas receptor axis (commentary; commentary)
• Nicotine may bind with the ACE2 receptor, particularly in people with COVID-19, and thus could interfere with further SARS-CoV-2-ACE2 binding (pre-print in silico study)
• Nicotine and cigarette smoke decrease levels of ACE2 in multiple organs
• Cytokine storms could be prevented or suppressed by nicotine through its impact on the cholinergic anti-inflammatory system; nicotine may inhibit hyperinflammation and platelet reactivity
• Poor COVID-19 outcomes in people who smoke could be driven by nicotine withdrawal when acutely ill, thus nicotine patches “should be urgently considered and discussed” (note, nicotine patch use in hospital is a common approach across conditions)
France has had to place restrictions on sales of nicotine replacement therapy because of fears it may start to be stockpiled for inappropriate use relating to COVID-19. Studies are underway testing nicotine replacement therapy in COVID-19 patients, and until results are available from those, there is no evidence to support the general public’s use of nicotine replacement therapy for COVID-19 infection. Nicotine replacement therapy is a mainstay of smoking cessation treatment and is safe and effective in this capacity.
CONCLUSIONS
• There are biologically plausible pathways through which nicotine may impact SARS-CoV-2, but the clinical significance of these is entirely unclear
• Early studies are underway regarding the role of nicotine replacement therapy as a therapeutic aid for COVID-19
• Evidence so far is too limited to inform any decisions about use of nicotine replacement therapy in COVID-19
• When used for smoking cessation, there is high certainty evidence that nicotine replacement therapy is safe and effective.
📚References:
👉COVID-19 and smoking: is nicotine the hidden link?👉Smoking and COVID-19
Scientific brief👉COVID-19 and smoking: A systematic review of the evidence🔸منتظر پرسش و پاسخهای بعدی باشید:
@GreatPharos |
@HealthNotes