School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia.
Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute and the University of Newcastle, Callaghan, Australia.
Respir Med. 2021 Jan;176:106237. doi: 10.1016/j.rmed.2020.106237. Epub 2020 Nov 19.
The ongoing COVID-19 pandemic has placed a spotlight on infectious diseases and their associations with host factors and underlying conditions. New data on the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus are entering the public domain at a rapid rate such that their distillation often lags behind. To minimise weak associations becoming perceived as established paradigms, it is imperative that methodologies and outputs from different studies are appropriately critiqued and compared. In this review, we examine recent data on a potential relationship between smoking and COVID-19. While the causal role of smoking has been firmly demonstrated in regard to lung cancer and chronic obstructive pulmonary disease, such associations have the benefit of decades' worth of multi-centre epidemiological and mechanistic data. From our analysis of the available studies to date, it appears that a relationship is emerging in regard to patients with a smoking history having a higher likelihood of developing more severe symptoms of COVID-19 disease than non-smokers. Data on whether COVID-19 has a greater incidence in smokers than non-smokers is thus far, contradictory and inconclusive. There is therefore a need for some caution to be exercised until further research has been conducted in a wider range of geographical settings with sufficient numbers of patients that have been carefully phenotyped in respect of smoking status and adequate statistical control for confounding factors.
持续的 COVID-19 大流行使人们对传染病及其与宿主因素和潜在疾病的关联有了更深入的了解。有关严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）病毒的新数据正在迅速进入公共领域，以至于对其的提炼常常落后。为了避免将弱关联误认为是既定的模式，必须对来自不同研究的方法和结果进行适当的评估和比较。在这篇综述中，我们研究了吸烟与 COVID-19 之间潜在关系的最新数据。虽然吸烟与肺癌和慢性阻塞性肺疾病之间的因果关系已经得到了明确的证实，但这些关联受益于数十年的多中心流行病学和机制数据。从我们对现有研究的分析来看，似乎有一个关系正在出现，即有吸烟史的患者比不吸烟者更有可能出现更严重的 COVID-19 症状。因此，关于 COVID-19 在吸烟者中的发病率是否高于不吸烟者的数据到目前为止是相互矛盾的，尚无定论。因此，需要谨慎对待，直到在更广泛的地理环境中进行更多的研究，这些研究应纳入足够数量的患者，对吸烟状况进行仔细的表型分析，并对混杂因素进行充分的统计控制。
