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/home/.sites/685/site2987125/web/vivid/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-clone.php on line 35 Wer raucht, hat mit Corona eher einen schweren Verlauf - VIVID - Fachstelle für Suchtprävention
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VIVID INSIDE

Wer raucht, hat mit Corona eher einen schweren Verlauf

Wie Studien belegen, sind Rauchende besonders für einen schweren Verlauf bei einer Infektion mit COVID-19 gefährdet.

Rauchende durch COVID-19 besonders gefährdet

Viele Studien zu COVID-19 teilen die Erkrankten in leichte Verläufe, mittlere Verläufe und schwere Verläufe. Als schwerer Verlauf zählte beispielsweise doppelseitige Lungenentzündung, Aufnahme in die Intensivstation, Notwendigkeit eines Beatmungsgeräts oder ausbleibende Besserung nach 14 Tagen.

Unter den Erkrankten mit „schwerem Verlauf“ sind überdurchschnittlich viele Rauchende. Das belegen inzwischen viele Studien. So zeigt ein Systematic Review über die aus China verfügbaren Daten für Raucherinnen und Raucher eine drastisch erhöhte Wahrscheinlichkeit für einen schweren Verlauf bei einer Corona-Infektion auf: Je nach Studie erhöht sich die Gefährdung um das Doppelte bis 14-Fache.

Eine der im Review analysierten Studien untersuchte den Unterschied zwischen Überlebenden und Gestorbenen. Unter den Überlebenden waren 4 Prozent Rauchende, unter den Gestorbenen 9 Prozent. Eine andere Studie zeigte, dass bei schweren Krankheitsverläufen 3,4 Prozent Rauchende und 6,9 Prozent Ex-Rauchende waren. Im Gegensatz dazu waren unter den leichten Krankheitsverläufen keine Rauchenden und nur 3,7 Prozent Ex-Rauchende.

Fraglich ist auch, ob die kolportierten häufig schwereren Verläufe bei Männern mit dem geschlechtsspezifischen Rauchstatus in China zusammenhängen: In China kommen auf eine rauchende Frau 23 rauchende Männer (2018: 288 Millionen Männer zu 12,6 Millionen Frauen). Auch in Spanien haben Männer eher einen schwereren Verlauf und versterben eher an Sars-CoV-2. In New York verstarben bisher fast doppelt so viele Männer wie Frauen am aktuellen Corona-Virus. Auch hier gilt als ein Erklärungsansatz, dass mehr Männer als Frauen rauchen.

Rauchende mit Corona 2,4 Mal so häufig auf Intensivstation

Insgesamt, resümiert dieser erste Systematic Review, benötigen Rauchende mit COVID-19 im Vergleich zu Nichtrauchenden 2,4 Mal so häufig die Aufnahme auf die Intensivstation.

Auch das British Medical Journal berichtet, dass bei einer Infektion mit COVID-19 ein großer Unterschied zwischen Rauchenden und Nichtrauchenden beobachtbar war: Während 12,4 Prozent der infizierten Rauchenden mit Atemmaschine versorgt, auf der Intensivstation behandelt wurden oder sogar daran verstarben, war das nur bei 4,7 Prozent der Nichtrauchenden der Fall. Auch beim verwandten MERS-Virus habe es unter den Verstorbenen eine Häufung an Rauchenden gegeben.

Mehr Andockstellen?

Eine kanadische Studie liefert einen weiteren Erklärungsansatz, warum das aktuelle Corona-Virus Rauchende kränker macht als Nichtrauchende: Bei Rauchenden könnte es mehr Andockstellen (ACE2-Rezeptoren) für das Virus Sars-CoV-2 geben. ACE2 dient in der Zelle als Andockstelle für das aktuelle Coronavirus. Wer raucht, hat eine höhere Konzentration von ACE2-Rezeptoren. Dieselbe Studie ergab: Ex-Raucher hatten ähnlich niedrige ACE2-Werte wie Menschen, die nie geraucht hatten.

Daten aus den USA legen nahe, dass auch die Menge der gerauchten Zigaretten eine Rolle für den Verlauf spielt. Je mehr Zigaretten jemand in seinem Leben schon geraucht hat, desto eher landet er im Krankenhaus und desto eher verstirbt er an COVID-19.

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