At the beginning of this new year of 2022, a news story about how cannabis can help fight COVID-19 was picked up by many non-cannabis media. These articles reported the findings of a study by Oregon State University into the effect that cannabis has on the cellular pathways that the COVID virus (an acronym for coronavirus disease) uses to invade the body.
While this research is certainly worth celebrating, the reality behind the message can be easily misunderstood in this age of social media. It seems that every time a positive clinical study relating to cannabis and COVID comes out, the world gets excited about the medical potential of weed as a miracle medicine to end the pandemic. Then later, when the details begin to emerge, the clickbait headlines disappear like leaves in the wind.
Fortunately, almost everyone in the cannabis industry kept a level head in the face of this study and affirmed that no, cannabis doesn’t prevent or cure coronavirus, although it does have the potential to help in a number of ways. Firstly, it can reduce the spread of the virus by binding to the receptors that the virus uses to infect the body. Secondly, it can reduce symptoms associated with the virus, since cannabis has natural anti-inflammatory properties.
Therefore, cannabis, to a certain extent, cannot cure COVID or stop you from contracting the virus. Still, it’s important to understand that it’s too early to make assumptions, especially when many people claim that cannabis use is the reason they haven’t had COVID-19 yet. For this reason, it is necessary to take a closer look at existing research on how cannabis might help (or harm) people against coronavirus.
Let’s review the most notable scientific studies to date.
Cannabis as a preventive agent against the virus
Research from Oregon State University shows that compounds found in hemp prevent the coronavirus from entering human cells
Without a doubt, this is the study on cannabis and COVID that has had the most repercussion in the media to date. According to this work, published on 10th January 2022 in the Journal of Natural Products, researchers at Oregon State University discovered that cannabigerolic acid (CBGA) and cannabidiolic acid (CBDA) “bind to the spike protein of SARS- CoV-2, by blocking a critical step in the process that the virus uses to infect people.”
Through a “revolutionary technique” known as affinity selection mass spectrometry (which makes it possible to determine the distribution of the molecules of a substance and classify them based on their compatibility with other molecules), researchers at the University of Oregon identified these two acidic cannabinoids capable of binding to the S protein of SARS-CoV-2, a spike-shaped sheath that adheres to cells, causing the virus to enter the body.
In this way, the spike protein would bind to these compounds in cannabis rather than to our cells, a discovery which could offer new avenues to prevent and treat the disease. This means that cell entry inhibitors, such as the acids in cannabis, could be used to prevent SARS-CoV-2 infection and also to shorten infections, by preventing virus particles from infecting human cells.
However, we must emphasise that this effect has not yet been observed in human subjects, as it has only been studied in Petri dishes, and there is a great disparity between an inanimate object and the human body. And while it’s a start, there’s a long way to go from a petri dish and mass spectrometer predictions. Furthermore, the compounds in question are found at very low levels in most cannabis strains; and can only be ingested through solvent-based extracts, not through smoking or cooking food.
Assuming clinical trials go well, the ultimate hope of the researchers is to develop a pill containing purified versions of these acidic cannabinoids as an adjunct to vaccination, for use after known exposure or by those who are immunocompromised.
CBD as a preventive agent after lung infection: cannabidol ‘slows down’ the progress of COVID-19 and stimulates the immune response
Beyond CBGA or CBDA, the cannabinoid obtained by the enzymatic degradation of the latter, CBD, is the best positioned in the race to fight the virus. A study published at the end of March 2021 found that cannabidiol inhibits SARS-CoV-2 infection because its metabolite, 7-OH-CBD, potently blocks the replication of COVID-19 in cells lung epithelial.
According to research, CBD induces the expression of the protein interferon and regulates its antiviral signaling pathway. In this way, CBD would act after cell infection, inhibiting the expression of viral genes and reversing many effects of the coronavirus on host gene transcription.
The study showed that a group of people who previously took CBD had a significantly lower incidence of SARS-CoV-2 infection compared to the rest of the population. This study highlights CBD and its active metabolite, 7-OH-CBD, as potential preventive agents and therapeutic treatments for SARS-CoV-2 in the early stages of infection.
In the US, hopes of a quick federal cannabis legalisation in 2022 are fading, but a long shot such as cannabis having a major impact on COVID transmission or remission could speed things up.
CBD, combined with terpenes, can become an even better virus preventative treatment with barely any side effects
But CBD, although it is the main actor in this miraculous cannabis fever, needs the help of other compounds to amplify its entourage effect, in this case the terpenes. At the beginning of March 2021, a study carried out by Israeli researchers linking COVID-19 and cannabis was published, highlighting the antiviral effect achieved by combining terpenes, natural compounds extracted from plants, and cannabidiol (CBD), a non-psychoactive component of the cannabis plant.
The study, published in preprint (that is, without peer review), evaluated the effect of a new formulation based on terpenes, called NT-VRL-1, to which cannabidiol was added, against the 229E strain of the coronavirus (HCoV) in lung cells. The results showed the ability of this formula to fight the virus when pre-incubated with host cells before infection appeared.
A much stronger effect was also found when CBD was applied together with the composition, created using 30 natural terpenes from cannabis as well as other plants, which suggests a synergistic or additive effect between the two.
Therefore, this combination is postulated as “a natural antiviral solution with minimal side effects that could be used individually or in addition to vaccines, as a preventive treatment”, according to the authors of the research. In addition, experts suggest inhalation as a route of administration, since the lungs are the organs most affected by COVID-19.
Cannabis as a treatment for COVID-19 infection
With variants of the coronavirus roaming the globe, could THC and CBD offer as-yet-unknown benefits in treating and staving off the deadly effects of the virus once a person is infected? While THC and CBD are known to help many illnesses, scientists around the world are looking at different combinations and strains to better understand how they can decrease long-term complications and death.
For most of 2020 and 2021, new studies have been emerging that support previous findings, creating a strong connection between CBD and THC as agents in the fight against the virus. In fact, CBD is already making a difference with COVID-19. Here are three quick facts you should know:
- CBD has already been shown to reduce inflammation in the body, directly related to the damage from cytokines released by the coronavirus. Because many COVID-19 patients do not die from the virus itself, but instead due to the body’s response to the virus, a process called a cytokine storm, which causes the body to go into “battle” mode, leading to breathing problems and an over-saturation of cytokines in the body. Every time a virus enters the body, it releases cytokines, a secretion from cells that respond to the virus, allowing the immune system to retaliate.
- CBD could be an effective treatment against cytokine storms, which are what wreaks the most havoc on the body. According to the medical journal Health Europa, “The first results of a study currently being carried out by the terpene manufacturer Eybna and the cannabis research and development company CannaSoul Analytics, both from Israel, seem to indicate that using the combination of terpenes and cannabinoids is up to two times more effective than the corticosteroid dexamethasone at reducing inflammation from COVID-19. The study has not yet been peer-reviewed.”
- More research is continuing to see the full effects of the virus and the ways that CBD can mitigate long-term damage. Research from the Rabin Medical Center in Beilinson, a leading Clalit HMO Research Institute hospital, holds a clue for future study. In recent research, the Center team found that out of 11 patients on the program, 8 saw an improvement in virus-related infections when using CBD.
THC is also no stranger to the fight. In JUne 2020, the journal Frontiers in Pharmacology published a study carried out by the University of South Carolina, which found that THC could effectively treat COVID complications and reduce mortality. The preliminary study found that, using mice, “THC led to 100% survival” with a compound that reduces cytokine inflammation, eliminating the “storm” or overreaction to the virus and discovered that lung-specific cells and bacteria played a critical role in understanding the extent and extinction of COVID-19.
Another study, published by the scientific journal Nature in January 2021, found that the cannabis strain Cannabis Sativa showed reduced inflammation against the virus and immune response markers. The study offered promising results, but emphasised caution with cannabis. One thing is for sure: the scientific community seems to be more widely accepting to cannabis use in the treatment newer diseases, leading to better education and understanding for all.
Cannabis as a risk factor for COVID-19
Cannabis use a new risk factor for severe COVID-19: study shows genetic link between cannabis use disorder and COVID hospitalizations
But it’s not all good news, there are also studies that contradict the miraculous news of claims that cannabis can treat the disease. Scientific evidence accumulated since the start of the SARS-CoV-2 pandemic has established diabetes, obesity, and smoking tobacco as behavioral risk factors that increase the chances of severe COVID-19 illness. A group of determining elements that could now have a new member in the shape of cannabis use, according to a study by the University of Washington.
In the study, peer-reviewed and published in the journal Biological Psychiatry in December 2021, the researchers tried to establish a relationship of genetic epidemiological models between cannabis use disorder (CUD) and hospitalisation for COVID-19.
To do this, they analysed two data sets: one of 357,806 people, of whom 14,089 had CUD, and the other of 1,206,629 people, of whom 9,373 were hospitalized for COVID. Additionally, they analyzed 7 million genetic variants to assess the association between CUD and severe COVID.
By comparing people with the variants to their COVID outcomes, the researchers found that genetic responsibility for cannabis use disorder accounted for up to 40% of genetically influenced risk factors such as body mass index (BMI) and diabetes, for severe COVID-19.
“This association suggests that excessive cannabis use may represent a modifiable pathway to minimise the severe capabilities of the coronavirus,” the researchers point out. So curbing excessive cannabis use can mitigate the impact of COVID-19. For this reason, they suggest including it in the list of behavioral risk factors.
In addition, the scientists conclude that the results suggest that a predisposition to have CUD and severe COVID-19 is due to a common biological mechanism, such as inflammatory conditions that facilitate the development of the most serious symptoms. However, they also limit their research and warn that more should be done, as there is a possibility that the results are due to a causal process.
Why smoking cannabis won’t protect you from COVID-19
As we have mentioned, the risk of serious illness and even death caused by COVID-19 increases with advanced age but is also concentrated among those who are immunosuppressed or whose health is compromised by different pathologies such as diabetes, cancer, heart disease and respiratory diseases. Many of the latter arise from smoking and therefore may increase the risk of death and disease among smokers (tobacco and/or cannabis).
The study by Oregon State University suggests that in the future, with enough research and money invested, cannabis compounds could be used to combat and even prevent COVID-19, which is both exciting and vindictive. But they make it very clear that smoking anything, including cannabis, is a risk factor for the disease, as it affects the lungs, so they recommend that people use tinctures or edibles if they choose to use cannabis, particularly if they have comorbidities associated with the most severe COVID-19 effects.
While it may be disappointing for some to learn that a joint is not enough to ward off the pandemic, this study is still welcome news for cannabis users and advocates, adding more evidence that this plant is worth the researchers’ investment of time and effort for many reasons. But, for the moment, the only thing that is clear is that cannabis will only help you relax in times of stress.
How else could cannabis treat COVID-19?
Because cannabis compounds such as CBD and THC have shown promising results in relieving pain and treating anxiety, although these therapeutic benefits have not been investigated in COVID-19 patients, they could offer interesting areas for future study.
It’s important to understand that, in addition to the common pathologies that can be treated with CBD, like pain and anxiety, there’s a host of other conditions that could also benefit from the therapeutic effects of this cannabinoid, such as hair loss, snoring, fungal foot infections, and even stuttering.
With symptoms of COVID-19 including body aches, sore throats, and headaches, many patients would welcome some relief from the pain. Cannabis has shown significant potential as an analgesic, particularly through its ability to increase the effects of serotonin, a neurotransmitter that can induce pain relief.
Finding out that you have COVID-19 can be an extremely stressful time. Due to its highly infectious nature, patients are isolated from friends and family. The frightening nature of the disease can also seriously affect mental health.
Cannabis compounds have displayed impressive anxiety-reducing qualities, particularly CBD, as it can increase serotonin activity and lower cortisol levels. Reducing these chemicals is essential for stress management, as serotonin reduces anxiety and cortisol is a hormone often found at higher levels in patients with anxiety and depression.
Thus, the stress of COVID-19 can upset the gastrointestinal system, fuel feelings of pain, prevent you from getting good-quality rest, and change your appetite (leading to weight gain or loss). Untreated anxiety can, in turn, lead to depression. It can also exacerbate a chronic disease you’re already suffering from, such as high blood pressure. All these factors work to debilitate the immune system, which is exactly what you don’t want to happen during a pandemic of planetary dimensions!
Existing research provides some hints about the therapeutic potential of cannabis against COVID-19, but does not really provide any evidence of clinically relevant effects on this disease. These compounds should be tested on animals, then on humans, to actually demonstrate reliably, beyond a Petri dish, that they are effective. And this is a long way from happening, assuming they work, which itself is by no means guaranteed.
It is very difficult for cannabis molecules at that level to actually become functional medicines. And since there are now treatments for COVID infections in at-risk patients (monoclonal antibodies, antivirals…) it is not advisable to use cannabis in place of the available treatments if a person is at high risk of serious consequences from COVID.
Sources and references in order of appearance:
- Cannabinoids Block Cellular Entry of SARS-CoV-2 and the Emerging Variants. Richard B. van Breemen, Ruth N. Muchiri, Timothy A. Bates, Jules B. Weinstein, Hans C. Leier, Scotland Farley y Fikadu G. Tafesse.
- Cannabidiol Inhibits SARS-CoV-2 Replication and Promotes the Host Innate Immune Response. Long Chi Nguyen, Dongbo Yang, Vlad Nicolaescu, Thomas J. Best, Takashi Ohtsuki, Shao-Nong Chen y J. Brent Friesen.
- In vitro evaluation of the activity of terpenes and cannabidiol against 2 Human Coronavirus E229. Lior Chatow, Adi Nudel, Iris Nesher, David Hayo Hemo, Perri Rozenberg y Hanna Voropaev.
- In search of preventative strategies: novel anti-inflammatory high-CBD Cannabis Sativa extracts modulate ACE2 expression in COVID-19 gateway tissues. Wang, B., Kovalchuk, A., Li, D., Ilnytskyy, Y., Kovalchuk, I., Kovalchuk, O.
- Administration of Δ9‐Tetrahydrocannabinol (THC) Post‐Staphylococcal Enterotoxin B Exposure Protects Mice From Acute Respiratory Distress Syndrome and Toxicity. Amira Mohammed, Hasan Alghetaa, Muthanna Sultan, Narendra P. Singh, Prakash Nagarkatti y Mitzi Nagarkatti
- Cannabis compounds exhibit anti-inflammatory activity in vitro in COVID-19-related inflammation in lung epithelial cells and pro-inflammatory activity in macrophages. Seegehalli M. Anil, Nurit Shalev, Ajjampura C. Vinayaka, Stalin Nadarajan, Dvora Namdar, Eduard Belausov, Irit Shoval, Karthik Ananth Mani, Guy Mechrez y Hinanit Koltai.
- Genetic Liability to Cannabis Use Disorder and COVID-19 Hospitalization. Alexander S.Hatouma, Claire L.Morrison, Sarah M.C.Colbert, Evan A.Winiger, Emma C.Johnson, Arpana Agrawala y Ryan Bogdanb.
- Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers. A W Zuardi, F S Guimarães y A C Moreira.
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