Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19)

Brake, Samuel James; Barnsley, Kathryn; Lu, Wenying; McAlinden, Kielan Darcy; Eapen, Mathew Suji; Sohal, Sukhwinder Singh

Further research on these products and their influence on the virulence of coronaviruses is urgently needed. Following the outbreak in New York City, Mayor Bill de Blasio announced that "If you are a smoker or a vaper that does make you more vulnerable," urging that now is the perfect time to quit [40] . Smokers, as a vulnerable group, must be supported to quit and should be advised to avoid areas where they may be liable to be exposed to Covid-19, especially smokers with preexisting respiratory health concerns. Smokers should be prioritized for vaccination when a vaccine is developed, particularly if it is found they are a key transmission source. Research on smoking and potential exacerbations of Covid-19 transmission and mortality should include waterpipes, electronic smoking devices, and "heat-not-burn" devices, such as IQOS devices. Further compounding this link between smoking and Covid-19 vulnerability are the comorbidities that have been identified as a significant increased risk factor for severe and fatal Covid-19. The link between smoking and comorbidities, such as diabetes and cardiovascular disease, have long been established [12] . As a research community, we must ask the questions: