Evaluation of the Efficacy of Nicotine Patches in SARS-CoV2 (COVID-19) Infection in Intensive Care Unit Patients

Inclusion criteria

• Patient ≥ 18 years
• Documented diagnosis of COVID 19 (according to the tests referenced on the list published on the website : https://covid-19.sante.gouv.fr.tests)
• Hospitalized in intensive care unit, intubated and mechanically ventilated for less than 48 hours
• Non-smoker and non-vaping or abstinent patient for at least 12 months
• Obtain written informed consent from a relative / relative / support person. In the absence of a close/relative/trusted person, the patient may be included according to the emergency procedure by the investigating doctor.
• Affiliated to a social security scheme or beneficiary of such a scheme (AME excluded)

Exclusion criteria

• Chronic respiratory failure defined by PaCO2> 60 mmHg in ambulatory patients (respiratory parameters at baseline).
• Mechanical ventilation at home (non-invasive mechanical ventilation or via a tracheostomy) with the exception of CPAP / BIPAP used only for sleep apnea syndromes
• Predictable mechanical ventilation duration <48 hours
• Moribund patient or death expected on the day of randomization, or with a SAPS II score> 90
• Cerebral deficiency with dilated areactive pupils or irreversible neurological pathology.
• Other concomitant severe pathology with an estimated life expectancy of less than 1 year
• Treatment with nicotine replacement therapy or varenicline or bupropion ongoing
• Contraindication for nicotine patches:

• Pregnant or breastfeeding women
• Allergy to nicotine or to one of the excipients of the transdermal patch
• Generalized skin pathologies
• Cerebrovascular accident or acute coronary syndrome for less than 3 months
• Pheochromocytoma
• Unstable or worsening angor
• Severe cardiac arrhythmia (Defined by wearing an automatic implantable defibrillator)
• Known severe heart failure (Defined, for this study, by systolic LV dysfunction with an LV ejection fraction (LVEF) of less than 30%)
• Severe renal failure (Defined by KDIGO stage 3)
• Severe hepatic impairment (Defined by a factor V <30%)
• Arteriopathy obliterating of the lower limbs stage III and IV
• Uncontrolled hyperthyroidism
• Gastroduodenal esophagitis or ulcer undergoing treatment or active
• Patient under guardianship or curatorship
• Patient deprived of liberty by judicial or administrative decision
• Patient included in another interventional trial evaluating a health product