The association of smoking with severity and mortality in COVID-۱۹ patients

Background: To investigate the relationship between smoking and contracting the severity andmortality of COVID-۱۹ infection.Methods: The present study was conducted on ۱۴۷ COVID-۱۹ patients who used to smoke overthe last three months and selected from the patients admitted to the COVID-۱۹ ward of ShahidMohammadi Hospital affiliated to Bandar Abbas University of Medical Sciences with confirmedPCR test results. The patients were divided into three groups based on the severity of theirdisease:۱. Mild: Patients with less than ۴۸ hours’ hospitalization, no hypoxia, and O۲ saturation≥۹۰%; ۲. Moderate: Patients with a hospitalization duration ≥۴۸ hours but no need for ICUadmission and who had not expired;۳. Severe: Patients needing ICU admission or who hadexpired. The indications for ICU admission included O۲ saturation ۳۰ beats/min. The relationshipbetween smoking history, history of using ARBs and ACE inhibitors, diabetes, hypertension,cardiovascular problems, and GFR was then assessed with severity of the disease. The effects ofsmoking history, history of ACEIs/ARBs use, history of hypertension, GFR ≤۶۰ mL/min, historyof cardiovascular problems, diabetes, LDH ≥۵۰۰ U/L, and lymphocyte count ≤۱۵۰۰ was then alsoassessed on COVID-۱۹-related deaths.Results: The mean age was ۶۰±۱۶ years in the severe group, ۵۳±۱۷ years in the moderate group,and ۴۷±۱۸ years in the mild group, suggesting a statistically significant difference between thethree groups. ۶۲% of the patients in the severe group, ۴۲% in the moderate group, and ۲۲% in themild group had a history of smoking, suggesting a statistically significant difference between thethree groups in this regard (P-value: ۰.۰۰۱) as well as history of ACEI/ARBs use, (P=۰.۰۴). Asignificant relationship was also observed between the patients' serum LDH and lymphopenia(lymphocyte count<۱۵۰۰) and the severity of the disease. Examining the risk factors affecting themortality of the disease showed that a history of smoking was not significant for mortality inCOVID-۱۹ patients. The adjusted OR in this regard was significant in the patients with GFR ≤۶۰(mL/min) (OR: ۲) and tin the patients with LDH≥۵۰۰ U/L (OR:۴), and also in the ones who had ahistory of hypertension and lymphopenia (OR:۱.۰۶ and ۴ respectively).Conclusion: The present study showed that the history of smoking before the infection ofCOVID-۱۹ had a significant relationship with the severity of the disease in patients with COVID-۱۹ infection. This result could change health and smoking prevention policies during the COVID-۱۹ pandemic and beyond.

کلیدواژه ها:

Smoking ، COVID-۱۹ ، Severity ، Mortality.