Retrospective evaluation of COVID-19 incidence during smoking cessation treatment with varenicline

Abstract

Background: Cholinergic anti-inflammatory pathway endogenously controls inflammatory processes through activation of the α7-nicotinic acetylcholine receptor (α7nAChR). Varenicline, used in smoking cessation therapy, is a full α7nAChR agonist with anti-inflammatory effects. In this study, the frequency of coronavirus disease (COVID-19) was evaluated in patients using varenicline as a smoking cessation treatment. Methods: In this retrospective cross-sectional study, records of the 111 patients admitted to Smoking Cessation Outpatient Clinic of XXXXX University Faculty of Medicine during the COVID-19 pandemic were evaluated. The development of COVID-19 disease according to the status of the patients being positive for SARS-COV-2 was evaluated comparatively in patients who received varenicline or not. Additionally, the disease symptoms were questioned. Results: SARS-CoV-2 PCR positivity was not detected in any of 38 patients who regularly used varenicline out of 68 patients evaluated. SARS-CoV-2 PCR positivity was detected in 13 (43.3%) of 30 patients who received other treatments or irregularly used varenicline (p<0.001). Conclusions: Patients under smoking cessation treatment did not develop COVID-19 during the period of varenicline use compared to non-users suggesting that the medication may have a protective role in the development of COVID-19 which might be further investigated by clinical trials.