Irina Petrache, MD

Irina Petrache, MD

National Jewish Health

Research Project:
Novel risk factors for severe COVID-19 lung disease

Grant Awarded:

  • COVID-19 Respiratory Virus Research Award

Research Topics:

  • basic biologic mechanisms
  • biomarkers
  • gene expression transcription
  • risk factors

Research Disease:

  • COVID-19

To better understand the mechanisms and clinical implications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we will determine if e-cigarette vaping and influenza virus are novel risk factors for severe COVID-19 lung disease, such as acute respiratory distress syndrome. There are high rates of co-infection of SARS-CoV-2 with other respiratory viruses, including influenza. This is important as we expect a resurgence of SARS-CoV-2 in the fall, during the flu season. Our studies suggest that vaping and low levels of influenza infection render the lung susceptible to a second hit with SARS-CoV-2. We will study this in detail in human cells and an animal model. Our work can impact public health by providing evidence for the need for flu vaccine in vapers, and to strongly encourage vaping cessation to decrease the morbidity of COVID-19.


We have shown that in human small airway epithelial cells, influenza virus infection increased expression of two SARS-CoV2 receptors, ACE2 and TMPRSS2. We also found the influenza virus increased ACE2 shedding and TMPRSS2 activation, which have been linked in the past with worse lung injury following virus infection. Influenza infection of these cells increases expression of a gene called STAT-1, which is linked to enhanced antiviral immune response, and that correlated significantly with ACE2 and TMPRSS2 expression. These data have been published in the European Respiratory Journal. We also performed experiments in animal models of COVID-19. Our data is being accumulated and in the final stages of analyses.

Page last updated: November 17, 2022

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