Cannabis and COVID-19

Cannabis and COVID-19

Is it a treatment or a risk?

The COVID-19 pandemic has been frightening for many, and it’s forced a lot of changes to everyday life. As people have shifted to wearing masks, distancing six feet apart and avoiding large gatherings, one big question has been on the minds of cannabis consumers everywhere: What about cannabis? Will it hurt or help my chances of surviving COVID-19?

The short answer is that researchers still can’t say what impact cannabis use will have on patients with COVID-19, but that hasn’t stopped them from exploring the question. Some studies conducted in 2020 have indicated that the active ingredients in cannabis may help with certain COVID-19 symptoms, while others suggest it could be a risk factor that makes you more likely to contract the disease.

More research is needed to clarify the answers to these questions—but the current research points the way toward areas that could be explored further.

Smoking anything increases risk. 

Dr. Donald Tashkin

Where There’s Smoke…

The concern over cannabis and COVID-19 started early. As the pandemic was just getting started, experts voiced caution that cannabis use might actually increase risk for COVID-19. Specifically, they were worried that smoking cannabis might make consumers’ lungs more susceptible to infection.

Dr. Donald Tashkin, for example, spoke out early in a piece for the LA Times, saying that “smoking anything increases risk.” Tashkin, a professor of medicine at UCLA who has spent years researching cannabis’s effects on the lungs, found that it can cause symptoms of bronchitis. Since other research has linked bronchitis to a more severe progression of COVID-19, this presents a worry for cannabis smokers.

Still, in a later interview with the San Francisco Chronicle, Tashkin explained that he doesn’t “believe that we have the data to answer this question as yet.”

He advised that “in the absence of evidence to the contrary, it would be safest to avoid smoking any product during the COVID-19 pandemic.”

An early study from researchers at the University of Western Australia also found evidence that cannabis use was tied to an increased risk of being infected with COVID-19. While this study was never peer-reviewed, it raised more worries that using cannabis could be a risk factor.

Cannabis and COVID-19

CBD: A Calm in the Storm?

But as the pandemic wore on, another line of research began to pop up, studies suggesting that cannabis or one of its active ingredients, CBD, might actually help those suffering from COVID-19. These studies pointed to CBD’s strong anti-inflammatory properties and suggested that it might help with a symptom of severe COVID-19 cases: the acute respiratory distress syndrome (ARDS) caused by cytokine storms.

Cytokines are proteins that help regulate our immune response. When an infection happens, cytokines trigger an inflammatory response, which usually helps to fight off the infection. But sometimes the body overreacts and releases way too many cytokines at once. This is called a cytokine storm, and the resulting inflammation can do serious damage. It can lead to ARDS, where breathing becomes difficult or impossible—and in severe cases, it can cause death.

The theory that CBD might be able to fight off these cytokine storms and the resulting ARDS was first posited by researchers from the University of Nebraska and the Texas Biomedical Research Institute. In their peer-reviewed article, they noted that CBD has already been shown to be a potent anti-inflammatory that can reduce the specific cytokines involved in cytokine storms. They suggested that this could make CBD helpful for treating severe cases of COVID-19.

Since then, other researchers have begun to investigate the theory experimentally. While human studies have yet to be conducted, promising results have come from preclinical studies. In a peer-reviewed study from Augusta University in Georgia, researchers tested the theory on mice. These researchers artificially induced a cytokine storm and ARDS, and once the mice began experiencing respiratory distress and damage to their lungs, they were treated with CBD.

The results were powerful. Not only did the CBD seem to suppress the cytokine storms, but the authors also reported that “these symptoms were totally or partially reversed” by CBD, including damage to the lungs from the intense inflammation.

Other studies have reported similar results. One study by Israeli cannabis R&D companies Eybna and CannaSoul Analytics looked at the impact of both CBD and specific cannabis terpenes on cytokine activity. Using a well-established cell assay to model the impacts of cytokine storms, these researchers tested CBD; a proprietary terpene blend; a combination of the terpene blend with CBD; and, singly, dexamethasone, a drug that is currently used to reduce cytokine storms in COVID-19 patients.

They found that the combination of CBD and terpenes was most effective at reducing cytokine activity and that both CBD and terpenes could outperform dexamethasone at the task.

“The results were powerful. Not only did the CBD seem to suppress the cytokine storms, but the authors also reported that “these symptoms were totally or partially reversed” by CBD, including damage to the lungs from the intense inflammation.”

Timing Might Be Everything

But other researchers have warned that cannabis’s anti-inflammatory properties might not always be of benefit in treating COVID-19. Some studies warn that cytokines and inflammation play an important role in fighting off early phases of infection—and while this immune suppression might help with severe cases of ARDS, it could also make people more susceptible to infection early on.

Still another study on mice added some complication to this theory. This research, from the University of South Carolina, looked at whether THC might also be able to help with ARDS in COVID-19 cases. Similar to the study using CBD, researchers experimentally induced ARDS. But unlike the previous study, these researchers gave mice THC right after infecting them. Surprisingly, 100% of those mice who were infected without a THC treatment died from the ARDS. But all those who were treated with THC survived and had less severe inflammation.

The results suggest that cannabis could not only help in severe cases of ARDS but might also help to prevent these cases from getting severe in the first place. Of course, it’s important to note that none of the mice in either study actually had COVID-19, just ARDS. Researchers may find different results with ARDS that arises from COVID-19 or in human populations.

There is a fair bit of promising preclinical evidence that cannabis could be a helpful treatment for COVID-19—and some suggesting it could be a risk factor. But we can’t know for sure what role cannabis might play in the disease’s progression without clinical trials on humans with COVID-19. While it’s unlikely we will see these studies anytime soon given restrictions on human research with cannabis, they could answer these important questions for the cannabis community.

By Emily Earlenbaugh