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It is likely that vitamin E is directly cytotoxic to lung cells (indicated by a yellow X), leading to necrosis, neutrophil recruitment and activation resulting in collateral damage, and noncardiac pulmonary edema

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The cigarette-induced disordering of the microbiota is probably an important factor to consider during viral infection. Reference: Cigarette smoke-induced disordered microbiota aggravates the severity of influenza A virus infection by Tsering Wthrich, Simone de Brot, Veronica Richina, Nadja Mostacci, Zora Baumann, Nathan G

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Gonzalez has explained that the song was not based on one literal incident