Comment by bird_monster | Hacker News Reader

Comment by bird_monster | Hacker News Reader

> The study in question will be randomized, national and multi-center, carried out double-blind, and should involve teams from Assistance Publique – Hôpitaux de Paris, Sorbonne University and Inserm. It is expected to include approximately 1,633 medical and non-medical caregivers, working in a health establishment, non-smokers (or former smokers who have quit smoking for more than 12 months), without a history of infection with COVID-19, and working with patients (with or without the virus).

> The researchers will administer nicotine patches to some of the participants for a period of 4 to 5 months, and then carry out a follow-up for 6 to 7 months. Of course, it is still too early to conclude exactly how nicotine interacts with the coronavirus. However, if nicotine is indeed confirmed as a protective factor, NRTs including e-cigarettes could play a pivotal role in controlling this pandemic.

Very curious to see how this goes. I would also love to see information as to why nicotine works this way, and if there are any non-nicotine options that have similar effects? Interesting stuff none the less.

Another interesting thing to find out: Is it just nicotine that has an effect? Or nicotine delivered via the respiratory system?

The nicotine patch trial will hopefully shed light on that as well.

In the meantime, it would be nice to see data comparing the hospitalization rates of smokeless tobacco users* vs. smokers and non-tobacco users.

* i.e. Chew, dip, and snus.

A quick literature search shows ample evidence of both immune suppressing and immune promoting effects of nicotine.

I didn’t see something that was a clear consensus, but it seemed like nicotine decidedly modulates the immune system. It seems whatever effects it has might do good things for covid.

Nicotine isn’t evil, and even not particularly addictive when not delivered via burning leaves. (components in smoke change how much enters the brain)

I've been wondering about this anyway. Isn't the covid that requires hospitalization due to an overreaction of the immune system? Maybe suppressing the immune system slightly is what helps here.

One of the primary treatments is a big dose of powerful steroids to suppress the immune response.

"even not particularly addictive when not delivered via burning leaves"

My personal experience is that it is even more addictive. First, with NRT (gum, lozenge) you can use nicotine much more frequently - e.g. even going to bed with lozenge in your mouth. Second, you can easily increase your dosage. 2mg piece of gum not doing it for you? Pop in a few more or move up to 4mg. Switch to mini-lozenge and you can suck on say 5 * 4mg lozenges at one time.

Hydroxychloroquine has been very controversial for some reason, but it is an immunosuppressant that's been used for years to treat sarcoidosis, and severe covid is a very similar inflammatory disease.

Some ideas from May soon after this was first observed: https://www.cebm.net/covid-19/nicotine-replacement-therapy/

> > The researchers will administer nicotine patches to some of the participants for a period of 4 to 5 months, and then carry out a follow-up for 6 to 7 months.

By that time, I'd expect widespread vaccinations particularly among older and at-risk people. Is this going to be anything more than a curiosity at that time? Maybe something to keep on the shelf for the next pandemic? Or a hedge in case the vaccine immunity is short-lived?

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