COPD and smoking increase risk of severe disease and death in COVID-19

Some reports have linked smoking to lower rates of COVID-19. But, here’s one COVID related reason not to smoke.

Some reports have claimed an association between smoking and lower rates of COVID-19. But, the World Health Organization has published a reminder, not only that “Tobacco kills more than 8 million people globally every year” and that “Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of respiratory diseases,” but that, with regards to COVID-19, “A review of studies by public health experts convened by WHO on 29 April 2020 found that smokers are more likely to develop severe disease with COVID-19, compared to non-smokers.”

Now, new research provides a strong caution for smokers regarding COVID-19. The systematic review and meta-analysis looks at COVID-19 and chronic obstructive pulmonary disease (COPD). COPD is a very common—but preventable—inflammatory lung disease that causes obstructed airflow. People with COPD suffer from difficulty breathing as well as coughing, wheezing and mucus production. It is caused by exposure to noxious gasses and particulates: usually the source of those gasses and particulates is cigarette smoking. Emphysema and bronchitis can contribute to COPD. COPD increases your risk of heart disease and lung cancer as well as several other conditions.

The systematic review and meta-analysis included 15 studies of 2473 people with COVID-19. It found, that, among people with COVID-19, current smokers are at greater risk of severe complications and have higher rates of death. COVID-19 sufferers with COPD had an 88% greater risk of severe disease and a higher mortality rate of 60%. Current smokers were 45% more likely to develop severe complications from COVID-19 than people who never smoked or formerly smoked. Current smokers had a higher mortality rate of as high as 38.5%.

This study suggests that COVID-19 sufferers with COPD are at greater risk of severe complications and death from COVID-19. It also suggests that people with COVID-19 who are current smokers are at increased risk of greater severity and mortality.

That means that, even if smoking did reduce your risk of getting COVID-19—which the World Health Organization reminds us is not yet proven—if you do get it, smoking increases your risk of more severe illness and of dying.

Some natural supplements have possibly important benefits for people with COPD. N-acetyl-cysteine (NAC) is used for bronchitis, pneumonia and COPD (Oxid Med Cell Longev 2018;2018: 2835787). NAC increases glutathione, the primary antioxidant in the lungs—and, importantly, helps the cilia to move mucous out of the airways. NAC also enhances immunity and acts as an anti-inflammatory.

A meta-analysis of 13 studies of people with chronic bronchitis or COPD found that people treated with NAC had a significant 25% reduction in fewer exacerbations of bronchitis or COPD (Eur Respir Rev 2015;24(137):451-61).

Some other natural measures have also been shown to help. An exotic herb known as Pelargonium sidoides is one of the best natural remedies for bronchitis. A double-blind study found that Pelargonium sidoides significantly decreased the number of exacerbations versus placebo (Respir Med 2013;10:691–701).

From a dietary standpoint, having more fiber in your diet has also been associated with a 33% lower risk of developing COPD. The benefit may come primarily from fiber from grains (Am J Epidemiol 2010;171(7):776-84). Eating more vegetables has also been shown to significantly reduce the risk (Prev Med 2009;49(2-3):184-9). Eating more soy may also be preventative: people who eat the most soy seem to have a significant 60% lower incidence of COPD (Respir Res 2009;10:56).


PLoS ONE 2020;15(5): e0233147


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The Natural Path is intended for educational purposes only and is in no way intended for self-diagnosis or self-treatment. For health problems, consult a qualified health practitioner for a comprehensive program.

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