Could the COVID-19 Positive Asymptomatic Tobacco Smoker be a Silent Superspeader?

Main Article Content

Yves Muscat Baron

Keywords

COVID-19;, particulate matter, smoking, 2nd hand smoking, viral vector

Abstract

There appears to be a connection between COVID-19 infection and an airborne microscopic pollutant called particulate matter which has been suggested to act as vector for viral transmission. The highest human exposure to particulate matter occurs during smoking and to a lesser extent applies to 2nd hand smoking.  This article offers a hypothetical proposition that particulate matter derived from tobacco smoking may act as COVID-19’s vector for infection transmission. With a background smoking Chinese male population of more than 66% and more than 70% of Chinese nonsmokers exposed to 2nd hand smoke the potential of exhaled smoke acting as a viral vector is significant.  If this hypothesis is proven, measures such as face protection to reduce coronavirus-laden particulate matter transmission, measures of social distancing and legislation to protect nonsmokers from contracting the infection through 2nd hand smoking should be implemented.

Downloads

Download data is not yet available.
Abstract 5 | PDF Downloads 2

References

1. Muscat Baron 2020a. Covid-19 Pandemic in relation to PM2.5, and Ambient Salinity – An Environmental Wake-up Call. MedRXiv https://doi.org/10.1101/ 2020.05.03. 20087056

2. Ghosh I. 2020. These Satellite Photos Show how COVID-19 Lockdowns Have Impacted Global Emissions: https: //www.weforum.org/agenda/2020/03/emissions-impact-coronavirus-lockdowns-satellites.

3. Chen Z, Peto R, Zhou M et al. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet: 2015:386;1447-1456 https://doi.org/10.1016/S0140-6736(15)00340-2

4. Korber B, Fischer WM, Gnanakaran S et al , Tracking Changes in SARS-CoV-2 Spike: Evidence that D614G Increases Infectivity of the COVID-19 Virus Cell 182, 812–827, August 20, 2020.

5. Zhang R, Li Y, Zhang AL, Yuan Wang Y, Molina MJ. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proc Natl Acad Sci U S A. 2020 Jun 30;117(26):14857-14863. doi: 10.1073/pnas.2009637117. Epub 2020.

6. Potera C. Outdoor Smoking Areas: Does the Science Support a Ban? Int J Environ Res Public Health. 020 Apr 23;17(8):2932.doi: 10.3390/ijerph17082932

7. Braun M, Koger F, Klingelhöfer D et al. Particulate Matter Emissions of Four Different Cigarette Types of One Popular Brand: Influence of Tobacco Strength and Additives. Int J Environ Res Public Health. 2019 Jan; 16(2): 263. doi: 10.3390/ijerph16020263

8. Yurkovetskiy L,, Xue Wang X, Pascal KE ey al, Structural and Functional Analysis of the D614G SARS-CoV-2 Spike Protein Variant bioRxiv https://doi.org/10.1101/2020.07.04.187757 (2020).

9. Wrapp D Nianshuang Wang, N, Kizzmekia S. Corbett K S, et al,. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science 13 Mar 2020:Vol. 367, Issue 6483, pp. 1260-1263 DOI: 10.1126/science.abb2507

10. Robson B. COVID-19 Coronavirus spike protein analysis for synthetic vaccines, a peptidomimetic antagonist, and therapeutic drugs, and analysis of a proposed achilles’ heel conserved region to minimize probability of escape mutations and drug resistance. Comput Biol Med2020 Apr 11 :doi: 10.1016/j.compbiomed. 2020.103749.

11. Aydin H, Al-Khooly D, Lee JE. Influence of hydrophobic and electrostatic residues on SARS-coronavirus S2 protein stability: insights into mechanisms of general viral fusion and inhibitor design. Protein Sci. 2014;23(5):603-17. doi: 1002/pro.2442.

12. Sanche S, Yen Ting Lin Y, Xu C, et al. High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2 Emerging Infectious Diseases 2020:26:7.

13. Katul G, Mrad A, Bonetti S, Manoli G, Parolari AJ. Global convergence of COVID-19 basic reproduction number and estimation from early-time SIR dynamics. PLoS One. 2020 Sep 24;15(9):e0239800. doi: 10.1371/journal.pone.0239800.

14. Liu Y., Gayle A., Wilder-Smith A., JR. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020 doi: 10.1093/jtm/taaa021.

15. Zhu Y, Xie J, Huang, Cao L. Association between short-term exposure to air pollution and COVID-19 infection: evidence from China. Sci. Total Environ., 727 (2020), Article 138704

16. Setti L, Passarini F, De Gennaro GD, Barbieri P, Perrone MG , Borelli M, Palmisani J, Di Gilio A, Prisco Piscitelli P, Miani A. Airborne Transmission Route of COVID-19: Why 2 Meters/6 Feet of Inter-Personal Distance Could Not Be Enough. Int J Environ Res Public Health. 2020 Apr 23;17(8):2932. doi:

17. Comunian S., Dongo D, Milani C and, Palestini P. Air Pollution and COVID-19: The Role of Particulate Matter in the Spread and Increase of COVID-19’s Morbidity and Mortality. Int. J. Environ. Res. Public Health 2020, 17(12), 4487; https://doi.org/10.3390/ijerph17124487.

18. Davel AP, Miriam Lemos M, Manfré Pastro L et al. Endothelial dysfunction in the pulmonary artery induced by concentrated fine particulate matter exposure is associated with local but not systemic inflammation. Toxicology 2012;295(1-3):39-46. doi: 10.1016/j.tox.2012.02.004.

19. Nguyen T, Cheng Po, Chi H. Hsiao-Chi Chuang's Lab (Inhalation Toxicology Research Lab). Particulate matter and SARS-CoV-2: A possible model of COVID-19 transmission. 2020. Science of The Total Environment DOI: 10.1016/j.scitotenv.2020.141532.

20. Smith J.C., Sausville E.L. Girish V et al. Cigarette Smoke Exposure and Inflammatory Signaling Increase the Expression of the SARS-CoV-2 Receptor ACE2 in the Respiratory Tract. Developmental Cell 2020: 53;514-529.e3.

21. Brunekreef Band Holgate ST Air pollution and health. Lancet, 360 (2002), pp. 1233-1242.


22. Pope C.A. and Dockery D.W. Health effects of fine particulate air pollution: lines that connect. J. Air & Waste Manag. Ass, 56 (2006), pp. 709-742

23. Wu X, Nethery R, Sabath B et al. Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. MedRxiv: 2020 doi: https://wwwdoi.org/ 10.1101/2020.04.05.20054502

24. Sedlmaier N, Hoppenheidt K, Krist H, et al. Generation of avian influenza virus (AIV) contaminated fecal fine particulate matter (PM(2.5)): genome and infectivity detection and calculation of immission. Vet Microbiol 2009;139:156 64. doi:10.1016/j.vetmic.2009.05.005

25. Cui, Y., Zhang, Z., Froines, J. et al. Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study. Environ Health 2, 15 (2003). https://doi.org/10.1186/1476-069X-2-15

26. Chen PS, Ta Tsai F, Kun Lin C et al. Ambient Influenza and Avian Influenza Virus during Dust Storm Days and Background Days 2010 https://doi.org/10.1289/ehp. 0901782

27. Ma Y, Zhou J, Yang S, et al. Assessment for the impact of dust events on measles incidence in Western China. Atmos Environ 2017;157:1–9.doi:10.1016/j.atmosenv.2017.03.010

28. Ferrari MJ, Grais RF, Bharti N, et al. The dynamics of measles in sub-Saharan Africa. Nature 2008;451:67984.doi:10.1038/nature06509pmid:http://www.ncbi.nlm.nih.gov/pubmed/18256664

29. Brown EG, Gottlieb S, Laybourn RL. Dust Storms and their possible effect on health: with special reference to the dust Storms in Kansas in 1935. Public Health Rep 1935;50:1369–83.doi:10.2307/4581653

30. Gupta SN and Gupta N. Modified Measles versus Rubella & Tobacco Smoking versus Adolescent Rubella Case Patients. Pediatric Education and Research. 2013; 1 Number 3.

31. Muscat Baron Y 2020b. Incidence and Case-Fatality Ratio of COVID-19 Infection in Relation to Tobacco Smoking, Population Density and Age Demographics in the USA: could Particulate Matter derived from Tobacco Smoking act as a Vector for COVID-19 Transmission? Journal of Clinical Cases and Reports. 2020;4:1-24

32. John Hopkins Resource Centre. https://coronavirus.jhu.edu/map

33. Muscat Baron Y 2020c. Elevated levels of PM2.5 in crowded Subways of Cities with High COVID-19 related Mortality. MedRXiv doi: https://doi.org /10.1101/2020.06.24.20138735.


34. Huang J, Zheng R and Sherry Emery S. Assessing the Impact of the National Smoking Ban in Indoor Public Places in China: Evidence from Quit Smoking Related Online Searches PLoS One. 2013; 8(6): e65577. doi: 10.1371/journal.pone.0065577

35. van Doremalen N, Morris D.H., Holbrook M.G. ET al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med 2020; 382:1564-1567. DOI: 10.1056/NEJMc2004973

36. Cattaruzza MS, Zagà V, Gallus S, D'Argenio P, Gorini G. Tobacco smoking and COVID-19 pandemic: old and new issues. A summary of the evidence from the scientific literature. Acta Biomed. 2020 May 11;91(2):106-112. doi: 10.23750/abm.v91i2.9698. PMID: 32420934; PMCID: PMC7569632.




1. Muscat Baron 2020a. Covid-19 Pandemic in relation to PM2.5, and Ambient Salinity – An Environmental Wake-up Call. MedRXiv https://doi.org/10.1101/ 2020.05.03. 20087056

2. Ghosh I. 2020. These Satellite Photos Show how COVID-19 Lockdowns Have Impacted Global Emissions: https: //www.weforum.org/agenda/2020/03/emissions-impact-coronavirus-lockdowns-satellites.

3. Chen Z, Peto R, Zhou M et al. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet: 2015:386;1447-1456 https://doi.org/10.1016/S0140-6736(15)00340-2

4. Korber B, Fischer WM, Gnanakaran S et al , Tracking Changes in SARS-CoV-2 Spike: Evidence that D614G Increases Infectivity of the COVID-19 Virus Cell 182, 812–827, August 20, 2020.

5. Zhang R, Li Y, Zhang AL, Yuan Wang Y, Molina MJ. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proc Natl Acad Sci U S A. 2020 Jun 30;117(26):14857-14863. doi: 10.1073/pnas.2009637117. Epub 2020.

6. Potera C. Outdoor Smoking Areas: Does the Science Support a Ban? Int J Environ Res Public Health. 020 Apr 23;17(8):2932.doi: 10.3390/ijerph17082932

7. Braun M, Koger F, Klingelhöfer D et al. Particulate Matter Emissions of Four Different Cigarette Types of One Popular Brand: Influence of Tobacco Strength and Additives. Int J Environ Res Public Health. 2019 Jan; 16(2): 263. doi: 10.3390/ijerph16020263

8. Yurkovetskiy L,, Xue Wang X, Pascal KE ey al, Structural and Functional Analysis of the D614G SARS-CoV-2 Spike Protein Variant bioRxiv https://doi.org/10.1101/2020.07.04.187757 (2020).

9. Wrapp D Nianshuang Wang, N, Kizzmekia S. Corbett K S, et al,. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science 13 Mar 2020:Vol. 367, Issue 6483, pp. 1260-1263 DOI: 10.1126/science.abb2507

10. Robson B. COVID-19 Coronavirus spike protein analysis for synthetic vaccines, a peptidomimetic antagonist, and therapeutic drugs, and analysis of a proposed achilles’ heel conserved region to minimize probability of escape mutations and drug resistance. Comput Biol Med2020 Apr 11 :doi: 10.1016/j.compbiomed. 2020.103749.

11. Aydin H, Al-Khooly D, Lee JE. Influence of hydrophobic and electrostatic residues on SARS-coronavirus S2 protein stability: insights into mechanisms of general viral fusion and inhibitor design. Protein Sci. 2014;23(5):603-17. doi: 1002/pro.2442.

12. Sanche S, Yen Ting Lin Y, Xu C, et al. High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2 Emerging Infectious Diseases 2020:26:7.

13. Katul G, Mrad A, Bonetti S, Manoli G, Parolari AJ. Global convergence of COVID-19 basic reproduction number and estimation from early-time SIR dynamics. PLoS One. 2020 Sep 24;15(9):e0239800. doi: 10.1371/journal.pone.0239800.

14. Liu Y., Gayle A., Wilder-Smith A., JR. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020 doi: 10.1093/jtm/taaa021.

15. Zhu Y, Xie J, Huang, Cao L. Association between short-term exposure to air pollution and COVID-19 infection: evidence from China. Sci. Total Environ., 727 (2020), Article 138704

16. Setti L, Passarini F, De Gennaro GD, Barbieri P, Perrone MG , Borelli M, Palmisani J, Di Gilio A, Prisco Piscitelli P, Miani A. Airborne Transmission Route of COVID-19: Why 2 Meters/6 Feet of Inter-Personal Distance Could Not Be Enough. Int J Environ Res Public Health. 2020 Apr 23;17(8):2932. doi:

17. Comunian S., Dongo D, Milani C and, Palestini P. Air Pollution and COVID-19: The Role of Particulate Matter in the Spread and Increase of COVID-19’s Morbidity and Mortality. Int. J. Environ. Res. Public Health 2020, 17(12), 4487; https://doi.org/10.3390/ijerph17124487.

18. Davel AP, Miriam Lemos M, Manfré Pastro L et al. Endothelial dysfunction in the pulmonary artery induced by concentrated fine particulate matter exposure is associated with local but not systemic inflammation. Toxicology 2012;295(1-3):39-46. doi: 10.1016/j.tox.2012.02.004.

19. Nguyen T, Cheng Po, Chi H. Hsiao-Chi Chuang's Lab (Inhalation Toxicology Research Lab). Particulate matter and SARS-CoV-2: A possible model of COVID-19 transmission. 2020. Science of The Total Environment DOI: 10.1016/j.scitotenv.2020.141532.

20. Smith J.C., Sausville E.L. Girish V et al. Cigarette Smoke Exposure and Inflammatory Signaling Increase the Expression of the SARS-CoV-2 Receptor ACE2 in the Respiratory Tract. Developmental Cell 2020: 53;514-529.e3.

21. Brunekreef Band Holgate ST Air pollution and health. Lancet, 360 (2002), pp. 1233-1242.


22. Pope C.A. and Dockery D.W. Health effects of fine particulate air pollution: lines that connect. J. Air & Waste Manag. Ass, 56 (2006), pp. 709-742

23. Wu X, Nethery R, Sabath B et al. Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. MedRxiv: 2020 doi: https://wwwdoi.org/ 10.1101/2020.04.05.20054502

24. Sedlmaier N, Hoppenheidt K, Krist H, et al. Generation of avian influenza virus (AIV) contaminated fecal fine particulate matter (PM(2.5)): genome and infectivity detection and calculation of immission. Vet Microbiol 2009;139:156 64. doi:10.1016/j.vetmic.2009.05.005

25. Cui, Y., Zhang, Z., Froines, J. et al. Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study. Environ Health 2, 15 (2003). https://doi.org/10.1186/1476-069X-2-15

26. Chen PS, Ta Tsai F, Kun Lin C et al. Ambient Influenza and Avian Influenza Virus during Dust Storm Days and Background Days 2010 https://doi.org/10.1289/ehp. 0901782

27. Ma Y, Zhou J, Yang S, et al. Assessment for the impact of dust events on measles incidence in Western China. Atmos Environ 2017;157:1–9.doi:10.1016/j.atmosenv.2017.03.010

28. Ferrari MJ, Grais RF, Bharti N, et al. The dynamics of measles in sub-Saharan Africa. Nature 2008;451:67984.doi:10.1038/nature06509pmid:http://www.ncbi.nlm.nih.gov/pubmed/18256664

29. Brown EG, Gottlieb S, Laybourn RL. Dust Storms and their possible effect on health: with special reference to the dust Storms in Kansas in 1935. Public Health Rep 1935;50:1369–83.doi:10.2307/4581653

30. Gupta SN and Gupta N. Modified Measles versus Rubella & Tobacco Smoking versus Adolescent Rubella Case Patients. Pediatric Education and Research. 2013; 1 Number 3.

31. Muscat Baron Y 2020b. Incidence and Case-Fatality Ratio of COVID-19 Infection in Relation to Tobacco Smoking, Population Density and Age Demographics in the USA: could Particulate Matter derived from Tobacco Smoking act as a Vector for COVID-19 Transmission? Journal of Clinical Cases and Reports. 2020;4:1-24

32. John Hopkins Resource Centre. https://coronavirus.jhu.edu/map

33. Muscat Baron Y 2020c. Elevated levels of PM2.5 in crowded Subways of Cities with High COVID-19 related Mortality. MedRXiv doi: https://doi.org /10.1101/2020.06.24.20138735.


34. Huang J, Zheng R and Sherry Emery S. Assessing the Impact of the National Smoking Ban in Indoor Public Places in China: Evidence from Quit Smoking Related Online Searches PLoS One. 2013; 8(6): e65577. doi: 10.1371/journal.pone.0065577

35. van Doremalen N, Morris D.H., Holbrook M.G. ET al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med 2020; 382:1564-1567. DOI: 10.1056/NEJMc2004973

36. Cattaruzza MS, Zagà V, Gallus S, D'Argenio P, Gorini G. Tobacco smoking and COVID-19 pandemic: old and new issues. A summary of the evidence from the scientific literature. Acta Biomed. 2020 May 11;91(2):106-112. doi: 10.23750/abm.v91i2.9698. PMID: 32420934; PMCID: PMC7569632.