tetano
Editor, Senior Moderator
J Intern Med
. 2020 Dec 3.
doi: 10.1111/joim.13190. Online ahead of print.
Tobacco smoking confers risk for severe COVID-19 unexplainable by pulmonary imaging
J Li[SUP] 1 2 [/SUP], X Long[SUP] 3 [/SUP], Q Zhang[SUP] 1 [/SUP], X Fang[SUP] 1 [/SUP], N Li[SUP] 1 [/SUP], B Fedorova[SUP] 4 [/SUP], S Hu[SUP] 5 [/SUP], Jh Li[SUP] 6 [/SUP], N Xiong[SUP] 1 2 [/SUP], Z Lin[SUP] 7 [/SUP]
Affiliations
Abstract
Background: COVID-19 is a new pneumonia. It has been hypothesized that tobacco smoking history may increase severity of this disease in the patients once infected by the underlying coronavirus SARS-CoV-2 because smoking and COVID-19 both cause lung damage. However, this hypothesis has not been tested.
Objective: Current study was designed to focus on smoking history in patients with COVID-19 and test this hypothesis that tobacco smoking history increases risk for severe COVID-19 by damaging the lungs.
Methods and results: This was a single-site, retrospective case series study of clinical associations, between epidemiological findings and clinical manifestations, radiographical or laboratory results. In our well-characterized cohort of 954 patients including 56 with tobacco smoking history, smoking history increased the risk for severe COVID-19 with an odds ratio (OR) of 5.5 (95% CI: 3.1-9.9; P = 7.3 ? 10[SUP]-8[/SUP] ). Meta-analysis of ten cohorts for 2891 patients together obtained an OR of 2.5 (95% CI: 1.9-3.3; P < 0.00001). Semi-quantitative analysis of lung images for each of five lobes revealed a significant difference in neither lung damage at first examination nor dynamics of the lung damage at different time-points of examinations between the smoking and nonsmoking groups. No significant differences were found either in laboratory results including D-dimer and C-reactive protein levels except different covariances for density of the immune cells lymphocyte (P = 3.8 ? 10[SUP]-64[/SUP] ) and neutrophil (P = 3.9 ? 10[SUP]-46[/SUP] ).
Conclusion: Tobacco smoking history increases the risk for great severity of COVID-19 but this risk is achieved unlikely by affecting the lungs.
Keywords: SARS-CoV-2; addiction; epidemiology; lung damage; substance use disorders.
. 2020 Dec 3.
doi: 10.1111/joim.13190. Online ahead of print.
Tobacco smoking confers risk for severe COVID-19 unexplainable by pulmonary imaging
J Li[SUP] 1 2 [/SUP], X Long[SUP] 3 [/SUP], Q Zhang[SUP] 1 [/SUP], X Fang[SUP] 1 [/SUP], N Li[SUP] 1 [/SUP], B Fedorova[SUP] 4 [/SUP], S Hu[SUP] 5 [/SUP], Jh Li[SUP] 6 [/SUP], N Xiong[SUP] 1 2 [/SUP], Z Lin[SUP] 7 [/SUP]
Affiliations
- PMID: 33270312
- DOI: 10.1111/joim.13190
Abstract
Background: COVID-19 is a new pneumonia. It has been hypothesized that tobacco smoking history may increase severity of this disease in the patients once infected by the underlying coronavirus SARS-CoV-2 because smoking and COVID-19 both cause lung damage. However, this hypothesis has not been tested.
Objective: Current study was designed to focus on smoking history in patients with COVID-19 and test this hypothesis that tobacco smoking history increases risk for severe COVID-19 by damaging the lungs.
Methods and results: This was a single-site, retrospective case series study of clinical associations, between epidemiological findings and clinical manifestations, radiographical or laboratory results. In our well-characterized cohort of 954 patients including 56 with tobacco smoking history, smoking history increased the risk for severe COVID-19 with an odds ratio (OR) of 5.5 (95% CI: 3.1-9.9; P = 7.3 ? 10[SUP]-8[/SUP] ). Meta-analysis of ten cohorts for 2891 patients together obtained an OR of 2.5 (95% CI: 1.9-3.3; P < 0.00001). Semi-quantitative analysis of lung images for each of five lobes revealed a significant difference in neither lung damage at first examination nor dynamics of the lung damage at different time-points of examinations between the smoking and nonsmoking groups. No significant differences were found either in laboratory results including D-dimer and C-reactive protein levels except different covariances for density of the immune cells lymphocyte (P = 3.8 ? 10[SUP]-64[/SUP] ) and neutrophil (P = 3.9 ? 10[SUP]-46[/SUP] ).
Conclusion: Tobacco smoking history increases the risk for great severity of COVID-19 but this risk is achieved unlikely by affecting the lungs.
Keywords: SARS-CoV-2; addiction; epidemiology; lung damage; substance use disorders.