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
N1 - Funding Information:
Daniel Puebla Neira, MD accepts full responsibility for the content of the manuscript including the data and analysis. Dr Kuo reports grants from the Agency of Healthcare Research and Quality (R01HS020642) during the conduct of this study. The authors acknowledge and greatly appreciate the assistance in the preparation of this manuscript by:, -En Shuo Hsu. Office of Biostatistics. UTMB, UTMB, -Sarah Toombs Smith, PhD, ELS. Research Communications Manager and Fellow, Sealy Center on Aging. Assistant Professor, Internal Medicine-Geriatrics. Assistant Professor, Graduate School of Biomedical Sciences. Faculty Associate, Hispanic Center of Excellence. UTMB, -Tara N. Atkins, MLIS. Reference Librarian. Moody Medical Library/Academic Resources. UTMB
Funding Information:
Daniel Puebla Neira, MD accepts full responsibility for the content of the manuscript including the data and analysis. Dr Kuo reports grants from the Agency of Healthcare Research and Quality ( R01HS020642 ) during the conduct of this study.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/6
Y1 - 2021/6
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.
AB - 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.
KW - COVID-19
KW - Hospitalization
KW - SARS-COV2
KW - Smoking
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U2 - 10.1016/j.rmed.2021.106414
DO - 10.1016/j.rmed.2021.106414
M3 - Article
C2 - 33915414
AN - SCOPUS:85106552891
SN - 0954-6111
VL - 182
JO - Respiratory Medicine
JF - Respiratory Medicine
M1 - 106414
ER -