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Smoking and risk of COVID-19 hospitalization.
Respir Med. 2021 06; 182:106414.RM

Abstract

RATIONALE

The association between smoking status and severe Coronavirus Disease 2019 (COVID-19) remains controversial.

OBJECTIVE

To assess the risk of hospitalization (as a marker of severe COVID-19) in patients by smoking status: former, current and never smokers, who tested positive for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2) at an academic medical center in the United States.

METHODS

We conducted a retrospective cohort study in patients with SARS-COV2 between March-1-2020 and January-31-2021 to identify the risk of hospitalization due to COVID-19 by smoking status.

RESULTS

We identified 10216 SARS-COV2-positive patients with complete documentation of smoking habits. Within 14 days of a SARS-COV2 positive test, 1150 (11.2%) patients were admitted and 188 (1.8%) died. Significantly more former smokers were hospitalized from COVID-19 than current or never smokers (21.2% former smokers; 7.3% current smokers; 10.4% never smokers, p<0.0001). In univariable analysis, former smokers had higher odds of hospitalization from COVID-19 than never smokers (OR 2.31; 95% CI 1.94-2.74). This association remained significant when analysis was adjusted for age, race and gender (OR 1.28; 95% CI 1.06-1.55), but became non-significant when analysis included Body Mass Index, previous hospitalization and number of comorbidities (OR 1.05; 95% CI 0.86-1.29). In contrast, current smokers were less likely than never smokers to be hospitalized due to COVID-19.

CONCLUSIONS

Significantly more former smokers were hospitalized and died from COVID-19 than current or never smokers. This effect is mediated via age and comorbidities in former smokers.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine. Department of Internal Medicine, University of Texas Medical Branch. Galveston, TX, USA. Electronic address: dapuebla@utmb.edu.Division of Pulmonary and Critical Care Medicine. Department of Internal Medicine, University of Texas Medical Branch. Galveston, TX, USA.Division of Pulmonary and Critical Care Medicine. Department of Internal Medicine, University of Texas Medical Branch. Galveston, TX, USA.Office of Biostatistics, University of Texas Medical Branch. Galveston, TX, USA.Office of Biostatistics, University of Texas Medical Branch. Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch. Galveston, TX, USA.Division of Pulmonary and Critical Care Medicine. Department of Internal Medicine, University of Texas Medical Branch. Galveston, TX, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

33915414

Citation

Puebla Neira, Daniel, et al. "Smoking and Risk of COVID-19 Hospitalization." Respiratory Medicine, vol. 182, 2021, p. 106414.
Puebla Neira D, Watts A, Seashore J, et al. Smoking and risk of COVID-19 hospitalization. Respir Med. 2021;182:106414.
Puebla Neira, D., Watts, A., Seashore, J., Polychronopoulou, E., Kuo, Y. F., & Sharma, G. (2021). Smoking and risk of COVID-19 hospitalization. Respiratory Medicine, 182, 106414. https://doi.org/10.1016/j.rmed.2021.106414
Puebla Neira D, et al. Smoking and Risk of COVID-19 Hospitalization. Respir Med. 2021;182:106414. PubMed PMID: 33915414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking and risk of COVID-19 hospitalization. AU - Puebla Neira,Daniel, AU - Watts,Abigail, AU - Seashore,Justin, AU - Polychronopoulou,Efstathia, AU - Kuo,Yong-Fang, AU - Sharma,Gulshan, Y1 - 2021/04/17/ PY - 2021/02/01/received PY - 2021/04/07/revised PY - 2021/04/11/accepted PY - 2021/4/30/pubmed PY - 2021/5/27/medline PY - 2021/4/29/entrez KW - COVID-19 KW - Hospitalization KW - SARS-COV2 KW - Smoking SP - 106414 EP - 106414 JF - Respiratory medicine JO - Respir Med VL - 182 N2 - RATIONALE: The association between smoking status and severe Coronavirus Disease 2019 (COVID-19) remains controversial. OBJECTIVE: To assess the risk of hospitalization (as a marker of severe COVID-19) in patients by smoking status: former, current and never smokers, who tested positive for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2) at an academic medical center in the United States. METHODS: We conducted a retrospective cohort study in patients with SARS-COV2 between March-1-2020 and January-31-2021 to identify the risk of hospitalization due to COVID-19 by smoking status. RESULTS: We identified 10216 SARS-COV2-positive patients with complete documentation of smoking habits. Within 14 days of a SARS-COV2 positive test, 1150 (11.2%) patients were admitted and 188 (1.8%) died. Significantly more former smokers were hospitalized from COVID-19 than current or never smokers (21.2% former smokers; 7.3% current smokers; 10.4% never smokers, p<0.0001). In univariable analysis, former smokers had higher odds of hospitalization from COVID-19 than never smokers (OR 2.31; 95% CI 1.94-2.74). This association remained significant when analysis was adjusted for age, race and gender (OR 1.28; 95% CI 1.06-1.55), but became non-significant when analysis included Body Mass Index, previous hospitalization and number of comorbidities (OR 1.05; 95% CI 0.86-1.29). In contrast, current smokers were less likely than never smokers to be hospitalized due to COVID-19. CONCLUSIONS: Significantly more former smokers were hospitalized and died from COVID-19 than current or never smokers. This effect is mediated via age and comorbidities in former smokers. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/33915414/Smoking_and_risk_of_COVID_19_hospitalization_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(21)00120-7 DB - PRIME DP - Unbound Medicine ER -