Infectious Disease

Heavy smoking will increase the chance of COVID-19 hospitalizations and demise

January 25, 2021

2 min read

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Lowe does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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The longer a person smoked, the greater their chances of hospitalization and death from COVID-19, an analysis of data from a single healthcare system revealed.

The relationship between smoking and COVID-19 severity remains unclear. The authors of a systematic review and meta-analysis published in July said smoking moderately increased the risk of severe COVID-19, contradicting a conclusion drawn by the authors of another April systematic review and meta-analysis that found no significant association.

A study in JAMA Internal Medicine adds to the growing body of evidence showing an association between smoking and COVID-19 severity. Photo source: Adobe Stock

In the new study Katherine E. Lowe, MSc, Colleagues at Lerner College of Medicine at Cleveland Clinic in Case Western Reserve compared COVID-19 severity in never-smokers (n = 6,020; mean age 47.8 years; 61.2% women) with those who smoked 0 to 10 pack years ( n = 341; mean age 56.4 years; 56% women), 10 to 30 pack years smoking (n = 400; mean age 65.2 years; 53% women) and more than 30 pack years smoking (n = 341); Mean age 71 years; 42.5% women). According to the National Cancer Institute, pack years are defined as the number of packets of cigarettes a person smokes each day multiplied by the number of years the person has smoked.

Lowe and colleagues reported that patients who smoked more than 30 pack years were 2.25 times more likely to be hospitalized (95% CI, 1.76-2.88) than those who had never smoked. These “heavy smokers” died 1.89 times more often than never-smokers after a COVID-19 diagnosis (95% CI, 1.29-1.76), according to the researchers.

“The association between cumulative smoking and adverse COVID-19 outcomes is likely mediated in part by comorbidities,” wrote Lowe and colleagues in JAMA Internal Medicine. “The odds ratios for all undesirable outcomes were weakened in the mediation models. There was no evidence of a change in the effect due to smoking status. Similar odds ratios were observed in both current and former smokers. “

The researchers admitted that the patient’s smoking history is not always properly documented in their electronic health records.

“However, this misclassification is likely to tend towards zero for the available results, which would underestimate the relationship between cigarette smoking and adverse COVID-19 results,” wrote Lowe and colleagues.

They said unequal access to health care may have affected patient data collection.

“Nonetheless, in this single central registry of patients who tested positive for COVID-19, we have shown that increased cumulative smoking is dose-dependently associated with a higher risk of hospitalization and mortality from COVID-19,” wrote Lowe et al Colleagues .

Reference:

Pack year. National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pack-year. Access to January. 21, 2021.

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