Smoking Is Correlated With the Prognosis of Coronavirus Disease 2019 (COVID-19) Patients: An Observational Study

doi:10.3389/fphys.2021.634842

. 2021 Mar 3:12:634842.

doi: 10.3389/fphys.2021.634842. eCollection 2021.

Smoking Is Correlated With the Prognosis of Coronavirus Disease 2019 (COVID-19) Patients: An Observational Study

Fei Peng¹, Si Lei¹, Quan Zhang¹, Yanjun Zhong², Shangjie Wu¹

Affiliations

¹ Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
² Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.

PMID: 33762967
PMCID: PMC7982916
DOI: 10.3389/fphys.2021.634842

Smoking Is Correlated With the Prognosis of Coronavirus Disease 2019 (COVID-19) Patients: An Observational Study

Fei Peng et al. Front Physiol. 2021.

. 2021 Mar 3:12:634842.

doi: 10.3389/fphys.2021.634842. eCollection 2021.

Authors

Fei Peng¹, Si Lei¹, Quan Zhang¹, Yanjun Zhong², Shangjie Wu¹

Affiliations

¹ Department of Respiratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
² Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.

PMID: 33762967
PMCID: PMC7982916
DOI: 10.3389/fphys.2021.634842

Abstract

Background: Cigarette smoking has been proven to be a risk factor in the development of many diseases. However, it remains controversial with respect to the relationship of smoking with COVID-19. The purpose of this study was to explore the role of smoking in COVID-19.

Methods: A total of 622 patients with COVID-19 in China were enrolled in the study. Corresponding clinical and laboratory data were collected and analyzed. Meanwhile, Kaplan-Meier curve and Cox regression analysis were employed to analyze the association of smoking with survival in patients with COVID-19.

Results: Smoking was statistically significant comparing non-survivors and survivors of patients with COVID-19 (P = 0.007). Males had higher proportion of smoking than females (91.9% vs. 8.1%, P < 0.001). Compared with the non-smoker, there was significant statistical difference in the incidence of cerebrovascular disease in smoking patients with COVID-19 (9.7% vs. 3.4%, P = 0.017). White blood cell count (6.3 vs. 5.4; P = 0.037), hemoglobin level (139.0 vs. 127.0; P < 0.001), and creatinine level (77.3 vs. 61.0; P < 0.001) were significantly increased in COVID-19 patients who smoked. Moreover, smoking patients showed a worse survival compared with non-smoking patients (Log Rank P = 0.045). After adjustment for age, gender and underlying diseases, patients with smoking still had higher risk of mortality than that of non-smoking patients (hazard ratio[HR] 1.897, 95% confidence interval [CI]1.058-3.402, P = 0.032).

Conclusion: Smoking was thought to be a risk factor in predicting the prognosis of COVID-19 and smoking patients might have a higher risk of mortality than that of the non-smoking patients.

Keywords: ACE2; COVID-19; SARS-CoV-2; cigarette; inflammation; prognosis; smoking.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**FIGURE 1**
The time-dependent risk of death in COVID-19 patients who smoked using Kaplan-Meier curve. Smoking patients showed a worse survival compared with those with non-smoking (Log Rank P = 0.045).

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[1] Agarwal A. K., Raja A., Brown B. D. (2020). Chronic Obstructive Pulmonary Disease. Treasure Island, FL: Statpearls. - PubMed

[2] Agarwal A. K., Raja A., Brown B. D. (2020). Chronic Obstructive Pulmonary Disease. Treasure Island, FL: Statpearls. - PubMed

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[4] Ahmed N., Maqsood A., Abduljabbar T., Vohra F. (2020). Tobacco smoking a potential risk factor in transmission of covid-19 infection. Pak. J. Med. Sci. 36 S104–S107. 10.12669/pjms.36.COVID19-S4.2739 - DOI - PMC - PubMed

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[9] Archie S. R., Cucullo L. (2020). Cerebrovascular and neurological dysfunction under the threat of covid-19: is there a comorbid role for smoking and vaping? Int. J. Mol. Sci. 21:3916. 10.3390/ijms21113916 - DOI - PMC - PubMed

[10] Archie S. R., Cucullo L. (2020). Cerebrovascular and neurological dysfunction under the threat of covid-19: is there a comorbid role for smoking and vaping? Int. J. Mol. Sci. 21:3916. 10.3390/ijms21113916 - DOI - PMC - PubMed

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Smoking Is Correlated With the Prognosis of Coronavirus Disease 2019 (COVID-19) Patients: An Observational Study

Affiliations

Smoking Is Correlated With the Prognosis of Coronavirus Disease 2019 (COVID-19) Patients: An Observational Study

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Affiliations

Abstract

Conflict of interest statement

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