The US Centers for Disease Control reported several risk factors for severe complications and mortality from coronavirus infection including a weakened immune system, asthma, chronic obstructive pulmonary disease (COPD) and, unsurprisingly, cigarette smoking. It follows then that those with a history of chronic marijuana use may have an elevated risk of severe complications and even death from coronavirus if they become infected.

Marijuana smoke causes inflammation in the airways and lungs that is nearly indistinguishable from that of cigarette smokers or people with bronchitis. Cigarette smokers have increased levels of angiotensin converting enzyme II (ACE-2) receptors that the corona virus uses to gain entry into host cells and cause infection, which explains the increased incidence and mortality from coronavirus among smokers. Although no study to date has investigated the effect of marijuana smoke on ACE-2 receptor expression, it stands to reason that marijuana smoke confers similar risks as cigarette smoke given the nearly identical inflammatory reactions they both elicit. Marijuana smoke also carries a much greater respiratory burden of carbon monoxide and tar. Furthermore, the length of time and depth with which marijuana smoke is held in the lungs causes long-term damage that usually results in a chronic bronchitis that resembles COPD or asthma. Marijuana smoke may also have immunosuppressive properties that further increase risk of coronavirus infection.

By deeming marijuana dispensaries ‘essential’ businesses, local and state officials may be unwittingly increasing vulnerability to infection and death among regular marijuana users both young and old. At this time of crisis, overburdened hospitals and healthcare workers can ill-afford to treat more coronavirus patients who might not have gotten sick were it not for their ability to continue to purchase and smoke marijuana.