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Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?
Intern Emerg Med. 2020 08; 15(5):845-852.IE

Abstract

The effects of smoking on Corona Virus Disease 2019 (COVID-19) are currently unknown. The purpose of this study was to systematically examine the prevalence of current smoking among hospitalized patients with COVID-19 in China, considering the high-population smoking prevalence in China (26.6%). A systematic review of the literature (PubMed) was performed on April 1. Thirteen studies examining the clinical characteristics of hospitalized COVID-19 patients in China and presenting data on the smoking status were found. The pooled prevalence of current smoking from all studies was calculated by random-effect meta-analysis. To address the possibility that some smokers had quit shortly before hospitalization and were classified as former smokers on admission to the hospital, we performed a secondary analysis in which all former smokers were classified as current smokers. A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0-3.4%) to 12.6% (95% CI 10.6-14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9-8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7-8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19.

Authors+Show Affiliations

Department of Public and Community Health, School of Public Health, University of West Attica, Leoforos Alexandras 196A, 11521, Athens, Greece. kfarsalinos@gmail.com.Department of Public and Community Health, School of Public Health, University of West Attica, Leoforos Alexandras 196A, 11521, Athens, Greece.Departments of Social and Behavioral Science and Epidemiology, College of Global Public Health, New York University, New York, USA.

Pub Type(s)

Journal Article
Meta-Analysis
Systematic Review

Language

eng

PubMed ID

32385628

Citation

Farsalinos, Konstantinos, et al. "Systematic Review of the Prevalence of Current Smoking Among Hospitalized COVID-19 Patients in China: Could Nicotine Be a Therapeutic Option?" Internal and Emergency Medicine, vol. 15, no. 5, 2020, pp. 845-852.
Farsalinos K, Barbouni A, Niaura R. Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? Intern Emerg Med. 2020;15(5):845-852.
Farsalinos, K., Barbouni, A., & Niaura, R. (2020). Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? Internal and Emergency Medicine, 15(5), 845-852. https://doi.org/10.1007/s11739-020-02355-7
Farsalinos K, Barbouni A, Niaura R. Systematic Review of the Prevalence of Current Smoking Among Hospitalized COVID-19 Patients in China: Could Nicotine Be a Therapeutic Option. Intern Emerg Med. 2020;15(5):845-852. PubMed PMID: 32385628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? AU - Farsalinos,Konstantinos, AU - Barbouni,Anastasia, AU - Niaura,Raymond, Y1 - 2020/05/09/ PY - 2020/04/05/received PY - 2020/04/23/accepted PY - 2020/5/10/pubmed PY - 2020/8/29/medline PY - 2020/5/10/entrez KW - ACE2 KW - COVID-19 KW - Hospitalization KW - Inflammation KW - Nicotine KW - SARS-CoV-2 KW - Smoking SP - 845 EP - 852 JF - Internal and emergency medicine JO - Intern Emerg Med VL - 15 IS - 5 N2 - The effects of smoking on Corona Virus Disease 2019 (COVID-19) are currently unknown. The purpose of this study was to systematically examine the prevalence of current smoking among hospitalized patients with COVID-19 in China, considering the high-population smoking prevalence in China (26.6%). A systematic review of the literature (PubMed) was performed on April 1. Thirteen studies examining the clinical characteristics of hospitalized COVID-19 patients in China and presenting data on the smoking status were found. The pooled prevalence of current smoking from all studies was calculated by random-effect meta-analysis. To address the possibility that some smokers had quit shortly before hospitalization and were classified as former smokers on admission to the hospital, we performed a secondary analysis in which all former smokers were classified as current smokers. A total of 5960 patients were included in the studies identified. The current smoking prevalence ranged from 1.4% (95% CI 0.0-3.4%) to 12.6% (95% CI 10.6-14.6%). An unusually low prevalence of current smoking was observed from the pooled analysis (6.5%, 95% CI 4.9-8.2%) as compared to population smoking prevalence in China. The secondary analysis, classifying former smokers as current smokers, found a pooled estimate of 7.3% (95% CI 5.7-8.9%). In conclusion, an unexpectedly low prevalence of current smoking was observed among patients with COVID-19 in China, which was approximately 1/4th the population smoking prevalence. Although the generalized advice to quit smoking as a measure to reduce health risk remains valid, the findings, together with the well-established immunomodulatory effects of nicotine, suggest that pharmaceutical nicotine should be considered as a potential treatment option in COVID-19. SN - 1970-9366 UR - https://www.unboundmedicine.com/medline/citation/32385628/Systematic_review_of_the_prevalence_of_current_smoking_among_hospitalized_COVID_19_patients_in_China:_could_nicotine_be_a_therapeutic_option L2 - https://dx.doi.org/10.1007/s11739-020-02355-7 DB - PRIME DP - Unbound Medicine ER -