tetano
Editor, Senior Moderator
Nicotine Tob Res
. 2021 Jan 9;ntab004.
doi: 10.1093/ntr/ntab004. Online ahead of print.
Impact of Tobacco Smoking on the risk of COVID-19.A large scale retrospective cohort study
Nicolas Paleiron[SUP] 1 [/SUP], Aur?lie Mayet[SUP] 2 [/SUP], Vanessa Marbac[SUP] 3 [/SUP], Anne Perisse[SUP] 3 [/SUP], H?l?ne Barazzutti[SUP] 1 [/SUP], Fran?ois-Xavier Brocq[SUP] 4 [/SUP], Fr?d?ric Janvier[SUP] 5 [/SUP], Dautzenberg Bertrand[SUP] 6 [/SUP], Olivier Bylicki[SUP] 1 [/SUP]
Affiliations
Abstract
Introduction: Preliminary reports indicated that smokers could be less susceptible to the coronavirus SARS-CoV-2, which causes Covid-19. However, once infected an increased risk of severe disease is reported. We investigated the association between smoking and COVID-19 during an outbreak of the disease on a naval vessel.
Methods: We conducted a cross-sectional, observational study on the 1769 sailors of a same navy aircraft carrier at sea exposed at the same time to SARS-CoV2 to investigate the link between tobacco consumption and Covid-19.
Results: Among the 1688 crewmembers (87% men; median age= 28 (IQR 23-35)) included, 1279 (76%) developed Covid-19 (1038 (62%) RT-PCR-positive and 241 (14%) with only clinical signs). One hundred and seven patients were hospitalized. The univariable analysis odds ratio (OR) for Covid-19 infection was 0.59 (95% confidence interval (CI), 0.45-0.78; P<0.001) for current smokers vs. former and nonsmokers; sex, body mass index or blood group had no significant impact. Crewmembers >50 years old had an increased risk of contracting Covid-19 (OR, 2.84 [95% CI, 1.30-7.5]; P=0.01). Multivariable analysis retained the lower risk of current smokers becoming infected (OR, 0.64 [0.49-0.84]; P<0.001) and age >50 years was significatively associated with Covid-19 (OR, 2.6 [1.17-6.9]; P=0.03).
Conclusions: Current smoking status was associated with a lower risk of developing Covid-19 but cannot be considered as an efficient protection against infection. Mechanism of the lower susceptibility of smokers to SARS-CoV-2 requires further research.
Implications: Recent epidemiologic data suggest a paradoxical link between smoking and Covid-19. Among the 1688 crewmembers (with an attack rate of 76% and exposed at the same time in the same place to SARS-CoV2), we found a significant lower risk for developing COVID-19 in current smokers (71%) versus former and non smokers (80%). This finding strongly supports the need for further research on nicotine physiological pathway and its impact on COVID-19 infection whilst emphasizing that tobacco smoking should not be considered as an efficient protection against COVID-19.
Keywords: Clinical epidemiology; Covid-19; Tobacco.
. 2021 Jan 9;ntab004.
doi: 10.1093/ntr/ntab004. Online ahead of print.
Impact of Tobacco Smoking on the risk of COVID-19.A large scale retrospective cohort study
Nicolas Paleiron[SUP] 1 [/SUP], Aur?lie Mayet[SUP] 2 [/SUP], Vanessa Marbac[SUP] 3 [/SUP], Anne Perisse[SUP] 3 [/SUP], H?l?ne Barazzutti[SUP] 1 [/SUP], Fran?ois-Xavier Brocq[SUP] 4 [/SUP], Fr?d?ric Janvier[SUP] 5 [/SUP], Dautzenberg Bertrand[SUP] 6 [/SUP], Olivier Bylicki[SUP] 1 [/SUP]
Affiliations
- PMID: 33420786
- DOI: 10.1093/ntr/ntab004
Abstract
Introduction: Preliminary reports indicated that smokers could be less susceptible to the coronavirus SARS-CoV-2, which causes Covid-19. However, once infected an increased risk of severe disease is reported. We investigated the association between smoking and COVID-19 during an outbreak of the disease on a naval vessel.
Methods: We conducted a cross-sectional, observational study on the 1769 sailors of a same navy aircraft carrier at sea exposed at the same time to SARS-CoV2 to investigate the link between tobacco consumption and Covid-19.
Results: Among the 1688 crewmembers (87% men; median age= 28 (IQR 23-35)) included, 1279 (76%) developed Covid-19 (1038 (62%) RT-PCR-positive and 241 (14%) with only clinical signs). One hundred and seven patients were hospitalized. The univariable analysis odds ratio (OR) for Covid-19 infection was 0.59 (95% confidence interval (CI), 0.45-0.78; P<0.001) for current smokers vs. former and nonsmokers; sex, body mass index or blood group had no significant impact. Crewmembers >50 years old had an increased risk of contracting Covid-19 (OR, 2.84 [95% CI, 1.30-7.5]; P=0.01). Multivariable analysis retained the lower risk of current smokers becoming infected (OR, 0.64 [0.49-0.84]; P<0.001) and age >50 years was significatively associated with Covid-19 (OR, 2.6 [1.17-6.9]; P=0.03).
Conclusions: Current smoking status was associated with a lower risk of developing Covid-19 but cannot be considered as an efficient protection against infection. Mechanism of the lower susceptibility of smokers to SARS-CoV-2 requires further research.
Implications: Recent epidemiologic data suggest a paradoxical link between smoking and Covid-19. Among the 1688 crewmembers (with an attack rate of 76% and exposed at the same time in the same place to SARS-CoV2), we found a significant lower risk for developing COVID-19 in current smokers (71%) versus former and non smokers (80%). This finding strongly supports the need for further research on nicotine physiological pathway and its impact on COVID-19 infection whilst emphasizing that tobacco smoking should not be considered as an efficient protection against COVID-19.
Keywords: Clinical epidemiology; Covid-19; Tobacco.