Accepted Articles
Back to the articles list |
Back to browse issues page
Sima Hashemipour1 
, Maryam Gheraati * 2, Milad Badri3 , Nafiseh Rastgoo1 , Aref Shokri1 , Sohrab Esmaielzade1 , Khadijeh Esmaielzade1
, Maryam Gheraati * 2, Milad Badri3 , Nafiseh Rastgoo1 , Aref Shokri1 , Sohrab Esmaielzade1 , Khadijeh Esmaielzade1
1- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
2- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran , Maryam.gheraati22@gmail.com
3- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
2- Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran , Maryam.gheraati22@gmail.com
3- Medical Microbiology Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
Abstract: (181 Views)
Objectives: There are inconsistent data about the association of smoking with prognosis in hospitalized patients with COVID-19. This inconsistency is so huge that some investigators hypothesized some protective roles of smoking against COVID-19 disease. This study has been designed to investigate the association of smoking with mortality in hospitalized patients with COVID-19.
Methods: This cross sectional study was conducted on 493 adult patients with COVID-19 disease. Other underlying diseases, clinical and laboratory findings and mortality rates were compared between smoking and non-smoking patients using univariate and multivariate analyses.
Results: Prevalence of current smoking among hospitalized patients was 6.1%. Clinical complaints and disease severity at admission were similar between smokers and non-smokers. Leukocytes count and blood sugar were higher in smokers compared to non-smokers (p=0.003, p=0.018, respectively). Rate of ICU admission and days of hospitalization were not different between smokers and non-smokers. However, smokers had a significantly higher mortality rate compared to non-smokers (36.7% vs 13.8%, respectively, p=0.001). After adjusting for significantly different variables in univariate analysis, smoking was associated with 3.78 times higher mortality rate (OR=3.78, 95% CI 1.48-9.67, P=0.005).
Conclusion: Smoking is an independent predictor of mortality in hospitalized patients with COVID-19.
Methods: This cross sectional study was conducted on 493 adult patients with COVID-19 disease. Other underlying diseases, clinical and laboratory findings and mortality rates were compared between smoking and non-smoking patients using univariate and multivariate analyses.
Results: Prevalence of current smoking among hospitalized patients was 6.1%. Clinical complaints and disease severity at admission were similar between smokers and non-smokers. Leukocytes count and blood sugar were higher in smokers compared to non-smokers (p=0.003, p=0.018, respectively). Rate of ICU admission and days of hospitalization were not different between smokers and non-smokers. However, smokers had a significantly higher mortality rate compared to non-smokers (36.7% vs 13.8%, respectively, p=0.001). After adjusting for significantly different variables in univariate analysis, smoking was associated with 3.78 times higher mortality rate (OR=3.78, 95% CI 1.48-9.67, P=0.005).
Conclusion: Smoking is an independent predictor of mortality in hospitalized patients with COVID-19.
References
1. COVID C, Team R, COVID C, Team R, COVID C, Team R, et al. Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019-United States, February 12-March 28, 2020. 2020;69(13):382. [DOI:10.15585/mmwr.mm6913e2] [PMID] [PMCID]
2. Mohammadi F, Badri M, Safari S, Hemmat N. A case report of rhino-facial mucormycosis in a non-diabetic patient with COVID-19: a systematic review of literature and current update. 2021 Sep 3;21(1):906.
https://doi.org/10.1186/s12879-021-06625-3 [DOI:10.1186/s12879-021-06625-3.] [PMID] [PMCID]
3. Allender S, Balakrishnan R, Scarborough P, Webster P, Rayner MJTc. The burden of smoking-related ill health in the UK. 2009;18(4):262-7. [DOI:10.1136/tc.2008.026294] [PMID]
4. Zohal M, EHTESHAMI AA, Zahmatkesh M, Lashkari M. PREVALENCE OF EXERCISE INDUCED ASTHMA AMONG PUPILS AND ITS RELATION WITH THEIR PARENTS'SMOKING HABITS. 2002.
5. Han L, Ran J, Mak Y-W, Suen LK-P, Lee PH, Peiris JSM, et al. Smoking and influenza-associated morbidity and mortality: a systematic review and meta-analysis. 2019;30(3):405-17. [DOI:10.1097/EDE.0000000000000984] [PMID]
6. Baskaran V, Murray RL, Hunter A, Lim WS, McKeever TMJPo. Effect of tobacco smoking on the risk of developing community acquired pneumonia: A systematic review and meta-analysis. 2019;14(7):e0220204. [DOI:10.1371/journal.pone.0220204] [PMID] [PMCID]
7. Arcavi L, Benowitz NLJAoim. Cigarette smoking and infection. 2004;164(20):2206-16. [DOI:10.1001/archinte.164.20.2206] [PMID]
8. Farsalinos K, Barbouni A, Niaura RJI, medicine e. Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option? 2020;15(5):845-52. [DOI:10.1007/s11739-020-02355-7] [PMID] [PMCID]
9. Emami A, Javanmardi F, Pirbonyeh N, Akbari AJAoaem. Prevalence of underlying diseases in hospitalized patients with COVID-19: a systematic review and meta-analysis. 2020;8(1). [DOI:10.1371/journal.pone.0241265] [PMID] [PMCID]
10. Gülsen A, Yigitbas BA, Uslu B, Drömann D, Kilinc OJPm. The effect of smoking on COVID-19 symptom severity: Systematic review and meta-analysis. 2020;2020. [DOI:10.1101/2020.08.15.20102699]
11. Changeux J-P, Amoura Z, Rey FA, Miyara MJCRB. A nicotinic hypothesis for Covid-19 with preventive and therapeutic implications. 2020;343(1):33-9. [DOI:10.5802/crbiol.8] [PMID]
12. Reddy RK, Charles WN, Sklavounos A, Dutt A, Seed PT, Khajuria AJJoMV. The effect of smoking on COVID‐19 severity: A systematic review and meta‐analysis. 2021;93(2):1045-56. [DOI:10.1002/jmv.26389] [PMID] [PMCID]
13. Umnuaypornlert A, Kanchanasurakit S, Lucero-Prisno DEI, Saokaew SJTid. Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis. 2021;19. [DOI:10.18332/tid/132411] [PMID] [PMCID]
14. Dai M, Tao L, Chen Z, Tian Z, Guo X, Allen-Gipson DS, et al. Influence of Cigarettes and Alcohol on the Severity and Death of COVID-19: A multicenter retrospective study in Wuhan, China. 2020;11. [DOI:10.3389/fphys.2020.588553] [PMID] [PMCID]
15. Liu W, Tao Z-W, Wang L, Yuan M-L, Liu K, Zhou L, et al. Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease. 2020. [DOI:10.1097/CM9.0000000000000775] [PMID] [PMCID]
16. Vardavas CI, Nikitara KJTid. COVID-19 and smoking: A systematic review of the evidence. 2020;18. [DOI:10.18332/tid/119324]
17. Karanasos A, Aznaouridis K, Latsios G, Synetos A, Plitaria S, Tousoulis D, et al. Impact of smoking status on disease severity and mortality of hospitalized patients with COVID-19 infection: a systematic review and meta-analysis. 2020. [DOI:10.1093/ntr/ntaa107] [PMID] [PMCID]
18. Mohammadi F, Kouzehgari SJJoID. Predicting the Prevalence of COVID-19 and its Mortality Rate in Iran Using Lyapunov Exponent. 2020;24(2):108-23. [DOI:10.32598/JQUMS.24.2.2415.1]
19. Wenzl TJLPOotEU. Smoking and COVID-19: A review of studies suggesting a protective effect of smoking against COVID-19. 2020.
20. Simons D, Shahab L, Brown J, Perski OJA. The association of smoking status with SARS‐CoV‐2 infection, hospitalization and mortality from COVID‐19: a living rapid evidence review with Bayesian meta‐analyses (version 7). 2021;116(6):1319-68. [DOI:10.1111/add.15276] [PMID] [PMCID]
21. Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, et al. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta-analysis. 2020;15(5):e0233147. [DOI:10.1371/journal.pone.0233147] [PMID] [PMCID]
22. Behl T, Kaur I, Bungau S, Kumar A, Uddin MS, Kumar C, et al. The dual impact of ACE2 in COVID-19 and ironical actions in geriatrics and pediatrics with possible therapeutic solutions. 2020:118075. [DOI:10.1016/j.lfs.2020.118075] [PMID] [PMCID]
23. Leung JM, Yang CX, Tam A, Shaipanich T, Hackett T-L, Singhera GK, et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. 2020;55(5). [DOI:10.1183/13993003.00688-2020] [PMID] [PMCID]
24. Wittebole X, Hahm S, Coyle S, Kumar A, Calvano S, Lowry SJC, et al. Nicotine exposure alters in vivo human responses to endotoxin. 2007;147(1):28-34.
25. Wang H, Yu M, Ochani M, Amella CA, Tanovic M, Susarla S, et al. Nicotinic acetylcholine receptor α7 subunit is an essential regulator of inflammation. 2003;421(6921):384-8. [DOI:10.1038/nature01339] [PMID]
26. Conti P, Ronconi G, Caraffa A, Gallenga C, Ross R, Frydas I, et al. Induction of pro-inflammatory cytokines (IL-1 and IL-6) and lung inflammation by Coronavirus-19 (COVI-19 or SARS-CoV-2): anti-inflammatory strategies. 2020;34(2):1.
27. Mabley J, Gordon S, Pacher PJI. Nicotine exerts an anti-inflammatory effect in a murine model of acute lung injury. 2011;34(4):231-7. [DOI:10.1007/s10753-010-9228-x] [PMID] [PMCID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Contact Information
Journal of Inflammatory Diseases
Shahid Bahonar Blvd, Qazvin University of Medical Sciences, Qazvin, Iran
Shahid Bahonar Blvd, Qazvin University of Medical Sciences, Qazvin, Iran
Journal Tel: +98 28 33357036
Website: http://journal.qums.ac.ir
E-mail: jresearchdpt@qums.ac.ir
