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Clinical trials have been launched, in Mulhouse and in several Parisian hospitals, to measure the supposed protective effect of nicotine against covid-19. A promising avenue for preventing contagion and limiting severe forms of the disease.
Tobacco is bad for your health. But the nicotine it contains could be an additional weapon in the fight against covid-19, both preventively and curatively. To measure it, clinical trials have just started in the Parisian hospitals of Pitié-Salpêtrière, Sainte-Anne and Gonesse, as well as at the Émile-Muller hospital in Mulhouse (Haut-Rhin). Led by Professor Zahir Amoura, internist at AP-HP (Assistance publique- Hôpitaux de Paris), they aim to administer nicotine, in medicinal form, to three groups of people: for preventive purposes, on the one hand , to uninfected voluntary caregivers (1,633 doctors, nurses, caregivers) to check whether or not they benefit from a protective effect; and with a therapeutic objective, on the other hand, to patients contaminated by Sars-Cov-2 - some hospitalized in medicine (220 patients), others admitted to intensive care (220 others) -, to see if their symptoms and complications can be decreased.
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Real patches or placebo
It is therefore more than 2,000 people who, subjected to these tests, will have transdermal nicotine patches (real, half of them, and placebo for the others). The dosages will change over the weeks. "The aim is to analyze, over a fairly long period (four months for caregivers recruited as preventive), the effectiveness and tolerance of the treatment. Addiction to nicotine should not, for example, generate an induction of smoking in non-smoking staff, ”states Professor Bertrand Dautzenberg, retired tobacco specialist-pulmonologist, president of Paris sans tabac and coordinator of the first report on vaping for the Department of Health.
"There is no question of experiencing a new runaway and false hope, like those aroused by hydroxycholoroquine! "
80% fewer smokers than expected
The hypothesis that nicotine could act in support of the fight against the coronavirus is not new. At the end of March 2020, a Chinese study identified five times fewer smokers out of 1,000 infected people than expected, given the total number of smokers in the country. A finding also made in the United States (13.4% of Americans addicted to cigarettes but only 1.3% of smokers out of 7,000 positive cases). Dr Konstantinos Farsalinos published a full report on this topic in early April.
Noting, too, the observation of a low number of smokers (5%) among the covid patients admitted to his department, the team of Professor Zahir Amoura, at Pitié-Salpêtrière, associated with the neurobiologist Jean-Pierre Changeux, has expanded the survey to the entire establishment. The result was clear: out of 480 covid patients (350 hospitalized patients and 130 positive cases received in consultation), there were "80% fewer smokers than expected", given the general population of the same sex and the same. age ".
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First conclusions next summer
At the end of April, the publication of these results led to a rush of consumers for nicotine substitutes (patches, chewing gum, lozenges), leading the government to publish an order to limit their sale. At the same time, the new Minister of Health, Olivier Véran, expressed his interest in the trials planned by Pitié-Salpêtrière.
The results of the newly launched clinical trials are not expected until next August (preventive use), September (intensive care patients), and December (hospitalized in medicine), although intermediate milestones are planned. Their methodology is intended to be extremely rigorous. "There is no question of experiencing a new runaway and false hope, like those aroused by hydroxycholoroquine! », Underlines Professor Bertrand Dautzenberg.
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