Please Be Safe: Vapers at Extra Risk of Coronavirus COVID-19

By Levin Simes
February 28, 2020
Number of genes suppressed from smoke exposure graph
Number of genes suppressed from smoke exposure graph

What Are the Risks of Coronavirus COVID-19 for Vapers and Smokers?

Will vapers and smokers suffer worse outcomes from coronavirus COVID-19?

The answer appear to be yes, after reviewing a combination of the known effects of smoking and vaping, combined with data from studies reviewing COVID-19 victims in Italy and China.

Vaping Mice vs Pneumonia and the Flu Virus

A study published in PLOS One subjected mice to two weeks of vape smoke, attempting to recreate the load seen in vapers. These mice plus control mice not exposed to vape smoke were exposed to either flu virus or bacteria that can cause pneumonia.

The vaping mice suffered these differing effects from the study:

  1. Vaping mice suffered impaired bacterial defenses, significantly reducing their ability to clear bacteria from their system vs non-vape exposed mice.
  2. Flu exposed mice that vaped suffered significantly worse effects from a virus exposure. The mice had reduced anti-viral defenses, and both suffered longer effects (increased morbidity) and higher rates of death (increased mortality).

The study showed exposure to vape smoke increased both morbidity and mortality in mice from a virus. How does vaping affect human lung tissue and immune response?

Lung Immune Suppression and Infection: Vaping Worse Than Smoking?

Recent studies have indicated that vaping may not only mimic cigarettes in causing pneumonia and 10,000 additional deaths per year in the United States from pneumonia, but may cause it at much greater rates than smoking traditional cigarettes.

With some studies already showing vaping causes high levels of initial infection from rhinovirus, even higher than cigarette smoke, new studies are adding to this by testing vaping smoke against cigarette smoke at immune suppression.

Researchers set out to determine whether the same effects could be seen in human e-cigarette users and published their findings in the American Journal of Physiology – Lung Cellular and Molecular Physiology. The researchers in this study found e-cigarette use results in suppression of immune and inflammatory-response genes just like cigarette smoke.  Vaping e-cigarettes was associated with suppression of 358 genes compared to 53 in cigarette smokers. The same 53 genes as smoking, plus 305 more. These genes play important roles in the body’s immune system and defense responses against fungal, bacterial and viral infections like the coronavirus.

The suppression of these genes, seven times as many as traditional cigarettes, leads additional evidence to the fear vaping may cause more lung complications, including complications from flu and other viruses such as COVID-19. Please review CDC guidelines and information on social distancing and ways to reduce risk, good advice for all, but possibly especially if you are vaping.

How Does Vaping Affect the Lungs?

Vaping affects the lung in multiple ways, including:

  1. Bronchial epithelia:
  2. Altered protein expression,
  3. inhibition of ciliary beating,
  4. inhibition of airway dehydration,
  5. increased in MUC5AC,
  6. cellular toxicity,
  7. increased cytokine secretion,
  8. altered gene expression
  9. Nasal epithelia
  10. Immunity gene downregulation
  11. Inhibition of ciliary beating
  12. Endothelia
  13. Impaired vasoconstriction
  14. Increased stiffness

Coronavirus is an attack on the lungs in severe cases, with virus replicating in the respiratory system, overloading the system with fluid, those suffering from weakened immune systems, lung capacity, or lung function such as the issues described above likely face a harder time overcoming this viral assault.

COVID-19 Novel Coronavirus Data on Smokers and Vapers

A Chinese study published February 28, 2020 examined data on smoking history among COVID-19 patients, and compared smokers vs non-smokers in outcome.

The study found several factors influenced the odds that coronavirus pneumona progressed in a patient: age, fever temperature at admission, respiratory failure, and smoking history.

The study found that 27% of the patients who suffered progression of COVID-19 pneumonia had a history of smoking, vs just 3% of those who recovered in the hospital without a progression of their disease.  This is more than significant, as the odds of a smoker having a progression of disease that resulted in respiratory support such as intubation was 14.3 times as likely vs a non-smoker.

From the article:

The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ2 = 9.291, P = 0.018).

Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ2 = 16.01, P = 0.001). Multivariate logistic analysis indicated […] history of smoking (OR, 14.285; 95% CI: 1.577–25.000; P = 0.018)

That means in a population of people the same age, showing the same symptoms, with the same degree of fever, we would expect 14 times as many among a pool of smokers to suffer bad outcomes than non-smokers..

More on the risks, from the National Institute on Drug Abuse:

As people across the U.S. and the rest of the world contend with coronavirus disease 2019 (COVID-19), the research community should be alert to the possibility that it could hit some populations with substance use disorders (SUDs) particularly hard. Because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape.

Everyone should be careful at this time, to avoid the risks of getting and transmitting to others COVID-19.  We want smokers and vapers to know they may face especially high risk, and should take seriously all the tools available to them to avoid exposure.

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