Respiratory Disease Unit, HIA Sainte-Anne, Toulon, France.
French Military Center for Epidemiology and Public Health (CESPA), Marseille, and UMR 912 SESSTIM: INSERM-IRD-Université Aix-Marseille, Marseille, France.
Nicotine Tob Res. 2021 Aug 4;23(8):1398-1404. doi: 10.1093/ntr/ntab004.
Preliminary reports indicated that smokers could be less susceptible to 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.
We conducted a cross-sectional, observational study on the 1769 sailors of the same navy aircraft carrier at sea exposed at the same time to SARS-CoV2 to investigate the link between tobacco consumption and Covid-19.
Among the 1688 crewmembers (87% men; median age = 28 [interquartile range 23-35]) included, 1279 (76%) developed Covid-19 (1038 [62%] reverse-transcriptase- polymerase chain reaction testing-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 < .001) for current smokers versus 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 = .01). Multivariable analysis retained the lower risk of current smokers becoming infected (OR, 0.64 [0.49-0.84]; p < .001) and age >50 years was significatively associated with Covid-19 (OR, 2.6 [1.17-6.9]; p = .03).
Current smoking status was associated with a lower risk of developing Covid-19 but cannot be considered as efficient protection against infection. The mechanism of the lower susceptibility of smokers to SARS-CoV-2 requires further research.
IRB no.: 0011873-2020-09.
(1) Recent epidemiologic data suggest a paradoxical link between smoking and COVID-19. (2) 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 significantly lower risk for developing COVID-19 in current smokers (71%) versus former and nonsmokers (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 efficient protection against COVID-19.
初步报告表明，吸烟者可能对导致 COVID-19 的冠状病毒 SARS-CoV-2 的易感性较低。然而，一旦感染，据报道严重疾病的风险增加。我们调查了在一艘海军舰艇上爆发疾病期间吸烟与 COVID-19 之间的关联。
我们对同一艘海军航母上的 1769 名水手进行了横断面、观察性研究，这些水手同时暴露于 SARS-CoV2 下，以调查吸烟与新冠病毒之间的联系。
在包括的 1688 名船员中（87%为男性；中位年龄=28[四分位距 23-35]），1279 名（76%）发生了 COVID-19（1038 名[62%]逆转录-聚合酶链反应检测阳性，241 名[14%]仅有临床症状）。107 名患者住院。单变量分析的 COVID-19 感染比值比（OR）为 0.59（95%置信区间[CI]，0.45-0.78；p<.001），当前吸烟者与前吸烟者和不吸烟者相比；性别、体重指数或血型没有显著影响。50 岁以上的船员感染 COVID-19的风险增加（OR，2.84[95%CI，1.30-7.5]；p=0.01）。多变量分析保留了当前吸烟者感染风险较低（OR，0.64[0.49-0.84]；p<.001），年龄>50 岁与 COVID-19 显著相关（OR，2.6[1.17-6.9]；p=0.03）。
当前的吸烟状况与患 COVID-19 的风险较低有关，但不能被认为是对感染的有效保护。吸烟者对 SARS-CoV-2 的低易感性的机制需要进一步研究。
IRB 编号：0011873-2020-09。
（1）最近的流行病学数据表明，吸烟与 COVID-19 之间存在矛盾联系。（2）在 1688 名船员中（发病率为 76%，同时在同一地点暴露于 SARS-CoV2），我们发现当前吸烟者（71%）与前吸烟者和不吸烟者（80%）相比，患 COVID-19 的风险显著降低。这一发现强烈支持进一步研究尼古丁生理途径及其对 COVID-19 感染的影响，同时强调吸烟不应被视为对 COVID-19 的有效保护。
