Smoking May Increase the Risk of COVID-19 Infection: Evidence from In Silico Analysis

Introduction: SARS-CoV2, first reported in December 2019 in Wuhan as COVID-19 causing respiratory illness, rapidly evolved into a pandemic owing to its very high infectivity. There is insufficient evidence about if and how smoking affects the risk of COVID-19 infection, and the reports on whether smoking increases or reduces the risk of respiratory infections, are contradictory. Therefore, the current study was designed to determine the effects of nicotine consumption on the infectivity of COVID-19.

Methods: We performed in silico computer simulation-based study. The structures of SARS-CoV2spike ectodomain, and its receptor ACE2, were obtained from PDB. The structure of nicotine and its metabolites NNK and NNAL were obtained from the PubChem chemical database. After optimization, they were interacted using AutoDock 4.2, to see the effect of nicotine, NNK, or NNAL presence on the docking of viral spike protein to its receptor ACE2.

Results: ACE2 vs spike protein interaction results were used as a control (ZDOCK score 1498.484, with four hydrogen bonds). The NNK+ACE2 vs spike protein docking formed 10 hydrogen bonds with the highest ZDOCK score of 1515.564. NNAL+ ACE2 vs spike protein interaction formed eleven hydrogen bonds with the ZDOCK score of 1499.371. Nicotine+ACE2 vs spike protein docking showed the lowest ZDOCK score of 1496.302 and formed 8 hydrogen bonds. Whereas, NNK+spike vs ACE2 interaction had a ZDOCK score of 1498.490 and formed eight hydrogen bonds. NNAL+spike vs ACE2 docking formed eleven hydrogen bonds with a ZDOCK score of 1498.482. And Nicotine+spike vs ACE2 interaction showed a ZDOCK score of 1498.488 and formed 9 hydrogen bonds.

Conclusions: The binding of nicotine to either spike of virus or its receptor ACE2 is not affecting the viral docking with the receptor. But binding of NNK, a metabolite of nicotine, is facilitating the viral docking with its receptor indicating that smoking may increase the risk of COVID-19 infection.