tetano
Editor, Senior Moderator
Respir Med
. 2021 Oct 30;190:106668.
doi: 10.1016/j.rmed.2021.106668. Online ahead of print.
Smoking status related to Covid-19 mortality and disease severity in a veteran population
Laura A Wilkinson[SUP] 1 [/SUP], Kari A Mergenhagen[SUP] 2 [/SUP], Michael T Carter[SUP] 1 [/SUP], Hubert Chua[SUP] 1 [/SUP], Collin Clark[SUP] 3 [/SUP], Bethany A Wattengel[SUP] 1 [/SUP], John A Sellick[SUP] 4 [/SUP], Ali A El-Solh[SUP] 5 [/SUP]
Affiliations
Abstract
Introduction: Cigarette smoking is associated with development of significant comorbidities. Patients with underlying comorbidities have been found to have worse outcomes associated with Coronavirus Disease 2019 (Covid-19). This study evaluated 30-day mortality in Covid-19 positive patients based on smoking status.
Methods: This retrospective study of veterans nationwide examined Covid-19 positive inpatients between March 2020 and January 2021. Bivariate analysis compared patients based on smoking history. Propensity score matching adjusted for age, gender, race, ethnicity, Charlson comorbidity index (0-5 and 6-19) and dexamethasone use was performed. A multivariable logistic regression with backwards elimination and Cox Proportional Hazards Ratio was utilized to determine odds of 30-day mortality.
Results: The study cohort consisted of 25,958 unique Covid-19 positive inpatients. There was a total of 2,995 current smokers, 12,169 former smokers, and 8,392 non-smokers. Death was experienced by 13.5% (n = 3503) of the cohort within 30 days. Former smokers (OR 1.15; 95% CI, 1.05-1.27) (HR 1.13; 95% CI, 1.03-1.23) had higher risk of 30-day mortality compared with non-smokers. Former smokers had a higher risk of death compared to current smokers (HR 1.16 95% CI 1.02-1.33). The odds of death for current vs. non-smokers did not significantly differ.
Conclusion: Compared to veteran non-smokers with Covid-19, former, but not current smokers with Covid-19 had a significantly higher risk of 30-day mortality.
Keywords: Coronavirus; Covid-19; Infectious disease; Smoking; Veterans.
. 2021 Oct 30;190:106668.
doi: 10.1016/j.rmed.2021.106668. Online ahead of print.
Smoking status related to Covid-19 mortality and disease severity in a veteran population
Laura A Wilkinson[SUP] 1 [/SUP], Kari A Mergenhagen[SUP] 2 [/SUP], Michael T Carter[SUP] 1 [/SUP], Hubert Chua[SUP] 1 [/SUP], Collin Clark[SUP] 3 [/SUP], Bethany A Wattengel[SUP] 1 [/SUP], John A Sellick[SUP] 4 [/SUP], Ali A El-Solh[SUP] 5 [/SUP]
Affiliations
- PMID: 34768074
- DOI: 10.1016/j.rmed.2021.106668
Abstract
Introduction: Cigarette smoking is associated with development of significant comorbidities. Patients with underlying comorbidities have been found to have worse outcomes associated with Coronavirus Disease 2019 (Covid-19). This study evaluated 30-day mortality in Covid-19 positive patients based on smoking status.
Methods: This retrospective study of veterans nationwide examined Covid-19 positive inpatients between March 2020 and January 2021. Bivariate analysis compared patients based on smoking history. Propensity score matching adjusted for age, gender, race, ethnicity, Charlson comorbidity index (0-5 and 6-19) and dexamethasone use was performed. A multivariable logistic regression with backwards elimination and Cox Proportional Hazards Ratio was utilized to determine odds of 30-day mortality.
Results: The study cohort consisted of 25,958 unique Covid-19 positive inpatients. There was a total of 2,995 current smokers, 12,169 former smokers, and 8,392 non-smokers. Death was experienced by 13.5% (n = 3503) of the cohort within 30 days. Former smokers (OR 1.15; 95% CI, 1.05-1.27) (HR 1.13; 95% CI, 1.03-1.23) had higher risk of 30-day mortality compared with non-smokers. Former smokers had a higher risk of death compared to current smokers (HR 1.16 95% CI 1.02-1.33). The odds of death for current vs. non-smokers did not significantly differ.
Conclusion: Compared to veteran non-smokers with Covid-19, former, but not current smokers with Covid-19 had a significantly higher risk of 30-day mortality.
Keywords: Coronavirus; Covid-19; Infectious disease; Smoking; Veterans.