Volume 25, Issue 2 (Summer 2021)                   2021, 25(2): 61-68 | Back to browse issues page

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Hashemipour S, Gheraati M, Badri M, Rastgoo N, Shokri A, Esmaielzadeh S et al . Impact of Smoking on the Mortality of Hospitalized Patients With COVID-19, Iran: A Cross-sectional Study. Journal of Inflammatory Diseases. 2021; 25 (2) :61-68
URL: http://journal.qums.ac.ir/article-1-3222-en.html
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.
Abstract:   (23643 Views)
Background: There are inconsistent data about the association of smoking with the prognosis of hospitalized patients with COVID-19. This inconsistency is so huge that some investigators have suggested some protective roles for smoking against COVID-19 disease. 
Objective: This study was 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:  The prevalence of current smoking among hospitalized patients was 6.1%. Clinical complaints and disease severity at admission were similar between smokers and non-smokers. Leukocyte count and blood sugar were higher in smokers compared to non-smokers (P=0.003, P=0.018, respectively). The rate of ICU admission and days of hospitalization were comparable between smokers and non-smokers. However, smokers had a significantly higher mortality rate than non-smokers (36.7% vs 13.8%, respectively, P=0.001). After adjusting for significantly different variables in univariate analysis, smoking was associated with a 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.
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Type of Study: Research | Subject: Virology

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]
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]

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