Nicotine can also play a role in balancing the immune system response in Covid-19 cases. Smokers have been the accidental guinea pigs that allowed for these findings:
A quarter of French adults smoke. Many people were surprised, therefore, when researchers reported late in April that only 5% of 482 covid-19 patients who came to the Pitié-Salpêtrière hospital in Paris between February 28th and April 9th were daily smokers. The ratios of smokers to non-smokers in earlier tallies at hospitals in America, China and elsewhere in France varied. But all revealed habitual smokers to be significantly underrepresented among those requiring hospital treatment for the illness.
A new paper in Toxicology Reports explains in detail why this may indeed happen. If the SARS-CoV-19 virus is not defeated early and replicates in huge numbers it creates an imbalances of the mixture of chemical messengers substances that keep the immune system under control. Then a so-called cytokine storm happens and the immune system starts to attack the organs. This explains why doctors see such a wide range of different organ failures in critical Covid-19 cases. The authors of the study conclude:
Once someone is infected with SARS-CoV-2, the immune system is mobilized. As the virus replicates, cell and viral debris or virions may interact with the nAChRs blocking the action of the cholinergic anti-inflammatory pathway. If the initial immune response is not enough to combat the viral invasion at an early stage, the extensive and prolonged replication of the virus will eventually block a large part the cholinergic anti-inflammatory pathway seriously compromising its ability to control and regulate the immune response. The uncontrolled action of pro-inflammatory cytokines will result in the development of cytokine storm, with acute lung injury leading to ARDS, coagulation disturbances and multiorgan failure.
Based on this hypothesis, COVID-19 appears to eventually become a disease of the nicotinic cholinergic system. Nicotine could maintain or restore the function of the cholinergic anti-inflammatory system and thus control the release and therapy for Covid-19 cases.
[See graphic at MoA website]