When smoke gets in your eyes. How many of you want to sing it rather than say it? Oh to be in that time frame rather than dealing with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the issue of when smoke gets in your lungs. Better known as COVID-19 (coronavirus disease 2019), the coronavirus, Rona, and so forth, not much more is known about it than was known in March of 2020 and the first situation red lockdown. Researchers are still arguing about the origin, when it started, what symptoms to watch for, whether to mask or not, and whether the vaccines do confer immunity. The Centers for Disease Control and Prevention (CDC) website has dedicated COVID-19 pages. Two years later, there are lots of theories, almost 80 million COVID cases with 1 million COVID deaths in the United States, and an escalating trend (81,000 a year in 2020 to 93,000 by early 2022) of overdose deaths. More than half of them are attributable to opioids, and states are experiencing escalating trends from 38% to 98% (CDC, 2022).

CDC. http://www.cdc.gov

https://www.cdc.gov/disasters/covid-19/wildfire_smoke_covid-19.html

https://www.cdc.gov/disasters/covid-19/covid-19_resources_for_professionals.html

https://www.cdc.gov/disasters/covid-19/reduce_exposure_to_wildfire_smoke_covid-1

The National Interagency Fire Center monitors natural disasters and has issued a warning for the upcoming wildfire season. Resource documents, including one archived from 2019, alert users of the CDC website to an increased potential for wildfires again this spring. Exposure to wildfire smoke air pollutants irritates the lungs, causing inflammation and altering immune function. Individuals who are exposed to the smoke are perceived to have increased susceptibility to respiratory infections including COVID-19. The information on this website is considered accurate, objective, and current because the website speaks with the authority of a government-sponsored agency.

BMJ Journals.https://thorax.bmj.com/content/77/1/65

Clift, A. K., von Ende, A., Tan, P. S., Sallis, H. M., Lindson, N., Coupland, C. A. C., Munafo, M. R., Aveyard, P., Hippisley-Cox, J., & Hopewell, J. C. (2022). Smoking and COVID-19 outcomes: An observational and Mendelian randomization study using the UK Biobank cohort. Thorax, 77, 65-73.

Using a cohort of over half a million study participants from the Biobank in the United Kingdom, researchers asked,

"What is the key question?

Does cigarette smoking increase risk of severe COVID-19?

What is the bottom line?

In this study using UK Biobank, we obtained congruent results from observational analyses (n = 421 469) and Mendelian randomization analyses (n = 281 105) regarding increased risk of COVID-19-related hospitalization and death in smokers.

Why read on?

Together, the results from our two analytical approaches support a causal effect of smoking on the risk of severe COVID-19."

This is original research made available through Open Access. Check the website of the British Medical Journals whose authority supports the accuracy, currency, objectivity, and coverage for additional information.

National Institutes of Health (NIH). National Library of Medicine (NLM). National Center for Biotechnology Information (NCBI).https://pubmed.ncbi.nlm.nih.gov/34328284/

Korzeniowska, A., Reka, G., Bilska, M., & Piecewicz-Szczesna, H. (2021). The smoker's paradox during the COVID-19 pandemic? The influence of smoking and vaping on the incidence and course of SARS-CoV-2 virus infection as well as possibility of using nicotine in the treatment of COVID-19-Review of the literature. Przeglad Epidemiologiczny, 75(1), 27-44. 10.32394/pe.75.03.

The title encompasses the aim of this literature review. Authors used scientific publications available up until November 14, 2020, from the PubMed platform to describe the current state of knowledge about the impact of traditional cigarettes and their nicotine content on the incidence and course of SARS-CoV-2 infection to determine the possibility of using nicotine to treat COVID-19 infections. As a cholinergic agonist and proinflammatory cytokines inhibitor, would nicotine reduce the ability for coronavirus to enter cells? Researchers found no reason to recommend smoking as a treatment approach but did indicate a need for further study. The importance of fighting addiction to reduce the adverse health effects of smoking was acknowledged. PubMed is the search engine for the official library for the federal government's National Institutes of Health. Information and resources here will be evaluated and meet standards for authority, accuracy, objectivity, and currency. The user may sometimes feel awkward to access the information or materials they are seeking.

NPJ Primary Care Respiratory Medicine.https://www.nature.com/articles/s41533-021-00223-1

van Westen-Lagerweij, N. A., Meijer, E., Meeuwsen, E. G., Chavannes, N. H., Willemsen, M. C., & Croes, E. A. (2021). Are smokers protected against SARS-CoV-2 infection (COVID-19)? The origins of the myth. NPJ Primary Care Respiratory Medicine, 31, 10.https://doi.org/10.1038/s41533-021-00223-1

Recently, a number of observational studies found an inverse relationship between smoking and SARS-CoV-2 infection (COVID-19), leading to a (social) media hype and confusion among scientists and, to some extent, the medical community. The finding that smoking is not associated with SARS-CoV-2 infection contradicts earlier studies, which found that smokers are more vulnerable to infections in general and to respiratory infections in particular. Smoking is known to increase the risk of infection of both bacterial and viral diseases, such as the common cold, influenza, and tuberculosis, and smoking is a putative risk factor for Middle East respiratory syndrome coronavirus infection. Could it be possible that SARS-CoV-2 is the big exception to the rule? To date, there is no strong evidence (i.e., evidence based on causal research) that smokers are protected against SARS-CoV-2 infection. Moreover, there is growing evidence that smokers have worse outcomes after contracting the virus than nonsmokers.

Johns Hopkins Medicine.https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coron

This link directs to the page on the John Hopkins Bayview Medical Center website where pulmonary expert, Panagis Galiatsatos, discusses his experience treating patients who have COVID-19. He explains the impact of smoking and other lung irritants on people at risk from-or infected with-the coronavirus from his perspective as a lung disease expert. The authority, accuracy, objectivity, and currency are equal to his knowledge and reputation with support from John Hopkins.

Pulmonology.https://www.healio.com/news/pulmonology/20220105/covid19-pandemic-impacting-smok

In December 2021, the University of California, San Francisco, Smoking Cessation Leadership Center, and Robert Wood Johnson Foundation hosted a media briefing highlighting the impact of the COVID-19 pandemic on smoking disparities in minority populations. In the United States, smoking rates have dropped by more than 50% over the past five decades, but particularly in minority populations, tobacco use remains the No. 1 cause of preventable death. The disparities depend on where and how people live. A panel of experts introduced new information on the association between COVID-19 and attempts to reduce smoking in minority populations. All authority, accuracy, objectivity, and currency are attributable to the host organizations.

WebMD. Coronavirus and Smoking.https://www.webmd.com/lung/covid-19-smoking-vaping#1

This is an informational discussion of all things smoking, vaping, and COVID related. No authority, accuracy, currency, or objectivity can be expected. However, the website does give a date range of 2005-2022 for information. It does bear the HON seal for Health on the Net.

American Thoracic Society Journals. American Journal of Respiratory and Critical Care Medicine.https://www.atsjournals.org/doi/10.1164/rccm.202005-1646LE

Polverino, F. (2020). Cigarette smoking and COVID-19: A complex interaction. American Journal of Respiratory and Critical Care Medicine, 202(3), 471-472.

Cigarette smoke is detrimental for the lungs, so it has been expected that data collection would find higher numbers of current smokers who were hospitalized patients with COVID-19 (SARS-CoV-2) rather than a lower prevalence of smokers seeming to question coexisting active smoking as a risk factor for COVID-19 pneumonia. It is possible that cigarette smoke may facilitate the entry of SARS-CoV-2. Further study is needed before decision making. The American Thoracic Society lends its authority to the credibility of this peer-reviewed article and assures users, mainly professionals, of the accuracy, objectivity, and currency of the data and the coverage of the website.

Frontiers in Physiology.https://www.frontiersin.org/articles/10.3389/fphys.2021.603850/full

Xie, J., Rui, Z., Wei, W., Ouying, C., & Yanhui, Z. (2021). COVID-19 and smoking: What evidence needs our attention? Frontiers in Physiology, 12, 603850.

This is a review of relevant research into the relationship between smoking and COVID-19. Some conclusions were that the smoking rate of patients with COVID-19 appears low but may not be accurately measured. It has been noted that smoking and nicotine can aggravate the risks associated with COVID-19 such as more severe symptoms and increased susceptibility and also can result in more severe forms of COVID-19. Although nicotine has shown some anti-inflammatory effects, they do not translate to treatment and cannot be considered a preventative measure. In fact, it may be spread by the likelihood of smokers gathering and sharing tobacco.

The accuracy, authority, and objectivity of this research are supported by the absence of any commercial or financial relationships that could be a potential conflict of interest, and funding was obtained from the Changsha Science and Technology Bureau in China (Grant No. kq1901085) and the Hunan Provincial Bureau of Science and Technology (Grant Nos. 2020ZK4065 and 2017WK2061). It is current, and the website is easy to use.

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