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This is surprising as smoking is generally associated with greatly exacerbating respiratory infections. Suggested mechanisms that may confer a protective effect of smoking include altered host cell expression of angiotensin-converting enzyme 2 (ACE2, the receptor the virus uses to infects cells)

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The study looked at the use of e-cigarettes by adults 18 years of age and older, based on data collected during a three-year period beginning in 2015, the researchers said