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COVID-19 Roundup: Higher Risks Linked to Smoking/Vaping; Latest on Saliva Test; and Vitamin D Deficiency

Research: Those Who Vape or Smoke Cigarettes are at Higher Risk of COVID-19 Infection, Severe Illness

A diagnosis of COVID-19 is up to seven times more likely among teens and young adults who use e-cigarettes (vaping devices) or smoke traditional cigarettes, especially if they have used both products, researchers have found.

The study’s authors [1] write: “The findings from a national sample of adolescents and young adults (ages 13-24) show that electronic cigarette use, and dual use of electronic cigarettes and cigarettes, are significant underlying risk factors for COVID-19.”

Healthcare providers, parents, schools, community-based organizations, and policymakers should make “youth aware of the connection between smoking and vaping and coronavirus disease,” they conclude.

It’s not just young adults who are at risk. Adults of any age who smoke are more vulnerable to severe illness from COVID-19, other researchers have found. In a separate study, researchers this month at Cedars-Sinai Medical Center in Los Angeles said smokers likely have an increased risk of being hospitalized or placed on a ventilator if they contract coronavirus. Smoking produces higher levels of ACE2 receptors – a protein – on the surface of the lung cells and those receptors make it easy for a viral invasion to take hold, state the Cedars-Sinai researchers.

“Smokers often have serious heart and lung health problems already,” said Joseph E. Ebinger, M.D., a cardiologist with the Smidt Heart Institute at Cedars-Sinai. “Add COVID-19 to the mix and you are likely to get a very sick patient. They just don’t have the physiological reserves to deal with the massive inflammatory attack brought on by the coronavirus.”

Since the beginning of the COVID-19 pandemic, medical experts have warned that the coronavirus — a respiratory pathogen that commonly attacks the lungs — most likely targets on the diseased lungs of smokers and vapers. Physicians and scientists are now trying to find a precise impact that that smoking and vaping is having on the coronvirus’s ability to infiltrate a person’s respiratory systems — and causing severe symptoms.

Cigarette smoking is the leading preventable cause of death in the U.S., according to the U.S. Centers for Disease Control and Prevention. Cigarette smoking causes more than 480,000 deaths each year in the U.S.

The potential longterm health hazards of vaping devices are still being studied. Research published last year in the American Journal of Preventive Medicine [2] tracked e-cigarette users for three years, and found that they had a 1.3-times higher risk of developing respiratory disease than people who did not use any tobacco product. Moreover, cigarette smokers had a 2.5-times higher risk — and those who both smoked and vaped had a 3.3-times higher risk.


Saliva COVID-19 Test May be as Effective as Nasal Swab, Study Indicates

A COVID-19 saliva test procedure developed by researchers at Yale University appears to perform at least as well as nasal swabs in a study of 70 hospital patients. If effective at a large scale, the saliva test protocol may help encourage more frequent use of self-collected samples.

In a letter published n the New England Journal of Medicine [3], Anne L. Wyllie, Ph.D., of the Yale School of Public Health in Connecticut, and her co-authors, recounted the tests done on the 70 patients. These patients already had tested positive for COVID-19 — confirmed with a positive nasopharyngeal swab specimen when admitted to Yale-New Haven Hospital.

“We tested saliva specimens collected by the patients themselves and nasopharyngeal swabs collected from the patients at the same time point by health care workers, the letter by the researchers states.

Over the following 10 days, saliva samples were compared to the original nasopharyngeal swab specimens. At 1 to 5 days after diagnosis, 81 percent of the saliva samples were positive, compared with 71 percent of the nasopharyngeal swab specimens, the co-authors reported. At days 6 to 10 after diagnosis, 76 percent of the saliva samples were positive, compared with 65 percent of the nasopharyngeal swab specimens.

There would be many advantages to saliva samples provided by the patients themselves if they are as accurate as nasal swabs.

State the study’s co-authors: “Collection of saliva samples by patients themselves also alleviates demands for supplies of swabs and personal protective equipment. Given the growing need for testing, our findings provide support for the potential of saliva specimens in the diagnosis of COVID-19 infection.”


Vitamin D Deficiency Linked to Higher Risk of COVID-19 Infection

Researchers have found a link between vitamin D deficiency and higher risk of getting infected with COVID-19.

The research team at the University of Chicago Medicine looked at 489 patients whose vitamin D level was measured within a year before tested for COVID-19. Patients who had vitamin D deficiency (less than 20ng/ml) were almost twice as likely to test positive for the COVID-19 coronavirus, compared to patients who had sufficient levels of vitamin D.
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“Vitamin D is important to the function of the immune system and vitamin D supplements have previously been shown to lower the risk of viral respiratory tract infections,” said David Meltzer, M.D., Ph.D., Chief of Hospital Medicine at UChicago Medicine and lead author of the study. “Our statistical analysis suggests this may be true for the COVID-19 infection.”

The study was published in JAMA Network Open [4].

Vitamin deficiency is widespread in the U.S. Half of Americans are deficient in Vitamin D, with much higher rates seen in Black Americans, Hispanics and individuals living in areas where it is challenging to get enough sun exposure during the winter.

Vitamin D helps balance the amount calcium and phosphate in our bodies, which is crucial for healthy bones, teeth and muscles.