To combat and prevent Covid-19, a problematic and unexpected ally could prove to be precious: nicotine. The hypothesis has reason to stir, but it should soon have the opportunity to be verified.
Once authorized to do so, a team from the Paris hospital of Pitié Salpêtrière will conduct clinical trials by administering nicotine substitutes to caregivers to see if the use of these patches protects them from the virus. Hospital patients and resuscitation patients will also be involved in these trials to find out if nicotine can be an effective treatment.
Exhibited in an article in the Biology Accounts of the Academy of Sciences and available since Tuesday on the Qios site, this track is advanced by four researchers including the neurobiologist Jean-Pierre Changeux, from the Institut Pasteur and the Collège de France , and the professor of internal medicine at Pitié Salpêtrière Zahir Amoura.
Five times less sick among daily smokers
It starts from an observation drawn up in this Parisian hospital and which was already taking shape in studies carried out elsewhere in the world, in China or in the United States in particular, but until then with the disputed methodology: whatever the age or sex, smokers are a rare commodity among patients infected with SARS-CoV-2.
While around a quarter of French people smoked daily in 2018 according to Santé Publique France, they represent only around 5% of the 343 hospitalized patients and 139 people who are more slightly affected by La Pitié.
As of April 8, Jean-Claude Delfraissy, the president of the Scientific Council, echoed on France Info of these "somewhat surprising facts at the epidemiological level": "We have noted that the vast majority of serious forms do not was not a smoker, there is an impression that tobacco protects against the virus via nicotine. "
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The study conducted at Pitié-Salpêtrière therefore confirms this observation. "This fact was already suspected, with this study, it is solidly and indisputably proven", underlines the pulmonologist Bertrand Dautzenberg.
It is now a question of knowing what specific element explains this lower prevalence. "Is it related to tobacco smoke or nicotine?" There are very strong arguments to think that it is the second ”, advances Bertrand Dautzenberg. The objective of clinical trials is to confirm or deny this possibility. For the four authors of the article on the “nicotinic hypothesis”, the answer would lie on the side of the acetylcholine receptor. By attaching to it, nicotine would prevent the coronavirus from attaching and entering the cells.
"Do not play with nicotine"
Researchers are well aware of the highly explosive potential of their work. “We must not forget that nicotine is responsible for tobacco addiction. Smoking has serious health consequences and remains a major health hazard, ”they say in conclusion. Rushing to his tobacconist to fill up on cartridges is therefore not a good idea, tobacco being the cause of 75,000 deaths each year in France. A figure almost four times the number of people who died from the Covid-19.
Bertrand Dautzenberg said for his part fear a possible rush on nicotine substitutes, over the counter, as could have been the case with chloroquine. “You shouldn't play with nicotine. If non-smokers buy and use a 21 mg patch, they will experience nausea after half an hour. The spent nicotine will continue to work for an hour or two and there is a risk of accident, he warns. If nicotine is ever given to a non-smoker, it should be done as part of a therapeutic trial and under the supervision of a doctor. "
However, the tobacco specialist advises smokers infected with SARAS-CoV-2 not to quit smoking without compensating for the amount of nicotine. There could be a risk that this sudden cessation could worsen the disease.
