E-cigarette users may be more susceptible to COVID-19 infection

Researchers at the Royal Adelaide Hospital (RAH) have found evidence that e-cigarette users may be more susceptible to COVID-19 infection than non-smokers.  

Both the nicotine in vapour as well as some flavourings appeared to increase key proteins which help the virus attach to, and enter, lung cells.  

Smoking and COVID-19 

Cigarette smokers may be more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the virus that leads to COVID-19. 

This may be partly because smokers appear to have a higher expression of the angiotensin-converting enzyme 2 (ACE2), the most well-known receptor that the virus binds to for entry into cells. 

However, what was unclear is if e-cigarette users may also have a higher susceptibility to SARS-CoV-2 than non-smokers, or how nicotine and/or flavourings might be involved. 

“We’re trying to help educate people. If they have an increased risk of infection, it’s important that they know so they can mitigate it, if they want to,” 

“We may then be able to reduce the number of COVID-19 cases and thus the number of people with severe disease.” 

Both nicotine and flavouring may contribute 

The researchers found that healthy bronchial epithelial cells (that line the surface of the lungs) exposed to e-cigarette vapour increased their expression of ACE2 as well as Transmembrane Serine Protease 2 (TMPRSS2), an enzyme that helps the virus enter the cell. 

Importantly, the researchers looked at the effect of flavour-free vapour with nicotine as well as different nicotine-free flavoured e-liquids separately; and found that both nicotine only e-liquid and certain flavoured e-liquids appear to increase susceptibility.  

“What this means is, if you’re an e-cigarette user, you may be at an increased risk of SARS-CoV-2 infection,” 

“So, it may be worthwhile for users take extra precautions to protect yourself from exposure to the virus, particularly if you have risk-factors for more severe COVID-19 as well.” 

Read the research 

Click here to read the published paper.