tetano
Editor, Senior Moderator
Eur J Integr Med
. 2021 Feb 18;101313.
doi: 10.1016/j.eujim.2021.101313. Online ahead of print.
Association of smoking history with severe and critical outcome in COVID-19 patients: A systemic review and meta-analysis
Huimei Zhang[SUP] 1 [/SUP], Shaodi Ma[SUP] 1 [/SUP], Tiantian Han[SUP] 1 [/SUP], Guangbo Qu[SUP] 1 [/SUP], Ce Cheng[SUP] 2 [/SUP], John Patrick Uy[SUP] 3 [/SUP], Mohammad Baseem Shaikh[SUP] 3 [/SUP], Qin Zhou[SUP] 4 [/SUP], Evelyn J Song[SUP] 5 [/SUP], Chenyu Sun[SUP] 3 [/SUP]
Affiliations
Abstract
Introduction: The highly infectious coronavirus disease 2019 (COVID-19) has now rapidly spread around the world. This meta-analysis was strictly focused on the influence of smoking history on the severe and critical outcomes on people with COVID-19 pneumonia. Methods: A systematic literature search was conducted in eight online databases before 1 February 2021. All studies meeting our selection criteria were included and evaluated. Stata 14.0 software was used to analyze the data. Results: A total of 109 articles involving 517,020 patients were included in this meta-analysis. A statistically significant association was discovered between smoking history and COVID-19 severity, the pooled OR was 1.55 (95%CI: 1.41-1.71). Smoking was significantly associated with the risk of admission to intensive care unit (ICU) (OR=1.73, 95%CI: 1.36-2.19), increased mortality (OR=1.58, 95%CI: 1.38-1.81), and critical diseases composite endpoints (OR=1.61, 95%CI: 1.35-1.93), whereas there was no relationship with mechanical ventilation. The pooled prevalence of smoking using the random effects model (REM) was 15% (95%CI: 14%-16%). Meta-regression analysis showed that age (P=0.004), hypertension (P=0.007), diabetes (P=0.029), chronic obstructive pulmonary disease (COPD) (P=0.001) were covariates that affect the association. Conclusions: Smoking was associated with severe or critical outcomes and increased the risk of admission to ICU and mortality in COVID-19 patients, but not associated with mechanical ventilation. This association was more significant for former smokers than in current smokers. Current smokers also had a higher risk of developing severe COVID-19 compared with non-smokers. More detailed data, which are representative for more counties, are needed to confirm these preliminary findings.
Keywords: COVID-19; mortality; severity; smoking; systematic review.
. 2021 Feb 18;101313.
doi: 10.1016/j.eujim.2021.101313. Online ahead of print.
Association of smoking history with severe and critical outcome in COVID-19 patients: A systemic review and meta-analysis
Huimei Zhang[SUP] 1 [/SUP], Shaodi Ma[SUP] 1 [/SUP], Tiantian Han[SUP] 1 [/SUP], Guangbo Qu[SUP] 1 [/SUP], Ce Cheng[SUP] 2 [/SUP], John Patrick Uy[SUP] 3 [/SUP], Mohammad Baseem Shaikh[SUP] 3 [/SUP], Qin Zhou[SUP] 4 [/SUP], Evelyn J Song[SUP] 5 [/SUP], Chenyu Sun[SUP] 3 [/SUP]
Affiliations
- PMID: 33619437
- PMCID: PMC7889467
- DOI: 10.1016/j.eujim.2021.101313
Abstract
Introduction: The highly infectious coronavirus disease 2019 (COVID-19) has now rapidly spread around the world. This meta-analysis was strictly focused on the influence of smoking history on the severe and critical outcomes on people with COVID-19 pneumonia. Methods: A systematic literature search was conducted in eight online databases before 1 February 2021. All studies meeting our selection criteria were included and evaluated. Stata 14.0 software was used to analyze the data. Results: A total of 109 articles involving 517,020 patients were included in this meta-analysis. A statistically significant association was discovered between smoking history and COVID-19 severity, the pooled OR was 1.55 (95%CI: 1.41-1.71). Smoking was significantly associated with the risk of admission to intensive care unit (ICU) (OR=1.73, 95%CI: 1.36-2.19), increased mortality (OR=1.58, 95%CI: 1.38-1.81), and critical diseases composite endpoints (OR=1.61, 95%CI: 1.35-1.93), whereas there was no relationship with mechanical ventilation. The pooled prevalence of smoking using the random effects model (REM) was 15% (95%CI: 14%-16%). Meta-regression analysis showed that age (P=0.004), hypertension (P=0.007), diabetes (P=0.029), chronic obstructive pulmonary disease (COPD) (P=0.001) were covariates that affect the association. Conclusions: Smoking was associated with severe or critical outcomes and increased the risk of admission to ICU and mortality in COVID-19 patients, but not associated with mechanical ventilation. This association was more significant for former smokers than in current smokers. Current smokers also had a higher risk of developing severe COVID-19 compared with non-smokers. More detailed data, which are representative for more counties, are needed to confirm these preliminary findings.
Keywords: COVID-19; mortality; severity; smoking; systematic review.