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World J Crit Care Med. Jul 9, 2022; 11(4): 228-235
Published online Jul 9, 2022. doi: 10.5492/wjccm.v11.i4.228
Medicinal nicotine in COVID-19 acute respiratory distress syndrome, the new corticosteroid
Farrukh Ahmad
Farrukh Ahmad, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Author contributions: Ahmad F contributed hypothesis generation, evidence gathering, drafting and editing of manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Farrukh Ahmad, MD, Staff Physician, Department of Internal Medicine, Saint Vincent Hospital, 123, Summer Street, Worcester, MA 01608, United States. farrukh2.ahmad@stvincenthospital.com
Received: November 14, 2021
Peer-review started: November 14, 2021
First decision: April 7, 2022
Revised: April 23, 2022
Accepted: June 18, 2022
Article in press: June 18, 2022
Published online: July 9, 2022
Core Tip

Core Tip: Cholinergic anti-inflammatory pathway is novel pathway of the inflammatory reflex. Activation of this pathway can suppress maladaptive inflammatory response seen in coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS). Nicotine is a potent activator of this pathway and may offer benefits in the management of COVID-19 ARDS, via immune suppressive effects similar to dexamethasone.