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Comment published on 2 May 2020, see J. Clin. Med. 2020, 9(5), 1321.
Open AccessEditorial

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

1
Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania 7248, Australia
2
School of Medicine, University of Tasmania, Hobart, Tasmania 7001, Australia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 841; https://doi.org/10.3390/jcm9030841
Received: 17 March 2020 / Accepted: 18 March 2020 / Published: 20 March 2020
(This article belongs to the Section Pulmonology)
The epicenter of the original outbreak in China has high male smoking rates of around 50%, and early reported death rates have an emphasis on older males, therefore the likelihood of smokers being overrepresented in fatalities is high. In Iran, China, Italy, and South Korea, female smoking rates are much lower than males. Fewer females have contracted the virus. If this analysis is correct, then Indonesia would be expected to begin experiencing high rates of Covid-19 because its male smoking rate is over 60% (Tobacco Atlas). Smokers are vulnerable to respiratory viruses. Smoking can upregulate angiotensin-converting enzyme-2 (ACE2) receptor, the known receptor for both the severe acute respiratory syndrome (SARS)-coronavirus (SARS-CoV) and the human respiratory coronavirus NL638. This could also be true for new electronic smoking devices such as electronic cigarettes and “heat-not-burn” IQOS devices. ACE2 could be a novel adhesion molecule for SARS-CoV-2 causing Covid-19 and a potential therapeutic target for the prevention of fatal microbial infections, and therefore it should be fast tracked and prioritized for research and investigation. Data on smoking status should be collected on all identified cases of Covid-19. View Full-Text
Keywords: ACE2 receptor; SARS-CoV-2; Covid-19; Smoking; COPD; Electronic cigarettes; Vaping; Heat-Not-Burn; IQOS ACE2 receptor; SARS-CoV-2; Covid-19; Smoking; COPD; Electronic cigarettes; Vaping; Heat-Not-Burn; IQOS
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Brake, S.J.; Barnsley, K.; Lu, W.; McAlinden, K.D.; Eapen, M.S.; Sohal, S.S. Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19). J. Clin. Med. 2020, 9, 841.

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