Smoking, nicotine and COVID-19 myths and facts. What is the evidence?

Expert view
Chairs: R. Costello (Dublin 9, Ireland), K. Antoniou (Heraklion, Greece), M. Humbert (Le Kremlin-Bicêtre, France)
Aims: To discuss whether smoking is a risk factor for SARS-COv-2 infection and severe disease, and how smoke emitted from a cigarette or exhaled by the smoker may constitute a vehicle for SARS-CoV-2 transmission. To discuss the epidemiologic evidence on the prevalence of smoking among COVID-19 inpatients; the association of smoking with COVID-19 severe disease and case-fatality rate. To discuss the biologic plausibility on how smoking encourages infection and worsens COPD and other respiratory diseases. To discuss mechanistic pathways that may explain the link between nicotine and COVID-19 progression and outcome. To highlight the conflicting evidence on COVID-19 and smoking, research gaps and implications for public health or healthcare preventative approaches and clinical risk assessment.

Is smoking a major risk factor for COVID-19 infection and severe disease? F. Filippidis (Oxford, United Kingdom)
Is nicotine the hidden link between COVID-19 and smoking? P. Russo (Rome, Italy)