Abstract
Abstract Currently, any association between smoking and COVID-19 susceptibility is conflicted as there is limited research especially on the impact of vaping. This systematic literature review will identify genes and signalling pathways that are affected by smoking or vaping that may play a role in altering the susceptibility of an individual to COVID-19. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, OVID and Web of Science databases, were searched (1946 to Nov 2021). Abstracts and subsequent full texts were screened for eligibility by RB, with EM and AB screening 5% each. Discrepancies were discussed and agreed between all. Papers were excluded for reasons such as focussing on comorbidities, immune cells or those with no exposure. Data from included papers detailing the exposure (type, duration and dose if applicable), pathway or gene of interest, sample type (species and cell type) and the overall findings, were extracted. Pathway analysis was undertaken to identify those pathways in common between smoking, vaping, nicotine and COVID-19 (g:Profiler and Cytoscape). We identified genes within the respiratory tract involved in both the initial viral response and those affected by smoking, vaping or nicotine exposure. This enabled us to determine signalling pathways of interest and therefore areas for further study. This systematic review will inform further research to identify any altered susceptibility and the risk of severe COVID-19 posed to smokers and vapers. This will inform Public Health Policies, highlighting vulnerable groups and provide guidance of relevance to both COVID-19 and other respiratory viruses.
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