Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
Int J Environ Res Public Health. 2021 Aug 25;18(17):8939. doi: 10.3390/ijerph18178939.
Smoking status does not indicate the amount or length of tobacco use, and thus, it is an imperfect measure to assess the association between cigarette smoking and severe coronavirus disease 2019 (COVID-19) outcomes. This investigation assessed whether cigarette smoking status, intensity of smoking (i.e., average daily packs of cigarettes smoked), duration of smoking, and pack-years of smoking are associated with severe outcomes among adults diagnosed with COVID-19.
We conducted a retrospective, cross-sectional study in which we identified consecutive patients diagnosed with COVID-19 at the University of Cincinnati healthcare system between 13 March 2020 and 30 September 2020 who had complete information on smoking status, severe COVID-19 outcomes, and covariates (i.e., demographics and comorbidities). We used logistic regression to evaluate the associations of smoking status and intensity of smoking with COVID-19 severity, defined as hospitalization, admission to intensive care unit (ICU), or death, adjusting for sociodemographics and comorbidities.
Among the 4611 COVID-19 patients included in the analysis, 18.2% were current smokers and 20.7% were former smokers. The prevalence of COVID-19 outcomes was 28.9% for hospitalization, 9.8% for ICU admission, and 1.4% for death. In the adjusted analysis, current smoking (AOR: 1.23, 95% CI: 1.02-1.49), former smoking (AOR: 1.28, 95% CI: 1.07-1.54), and pack-years of smoking (AOR: 1.09, 95% CI: 1.02-1.17) were associated with a higher prevalence of hospitalization. Average daily packs of cigarettes smoked was associated with a higher prevalence of hospitalization (AOR: 1.30, 95% CI: 1.10-1.53) and ICU admission (AOR: 1.23, 95% CI: 1.04-1.44).
Smoking status, pack-years, and intensity of smoking were associated with hospitalizations in patients with COVID-19 and intensity of smoking was associated with ICU admission. The findings underscore the need for detailed information beyond smoking status when evaluating smokers with COVID-19 so that the potential for adverse sequelae may be optimally managed in at-risk patients.
吸烟状况并不能表明吸烟量或吸烟时间的长短，因此，用它来评估吸烟与严重 2019 冠状病毒病（COVID-19）结局之间的关系并不准确。本研究评估了成年 COVID-19 患者的吸烟状况、吸烟强度（即平均每日吸烟包数）、吸烟持续时间和吸烟年包数是否与严重结局相关。
我们进行了一项回顾性、横断面研究，在这项研究中，我们确定了在 2020 年 3 月 13 日至 2020 年 9 月 30 日期间，在辛辛那提大学医疗系统被诊断为 COVID-19 的连续患者，这些患者的吸烟状况、COVID-19 严重结局以及协变量（即人口统计学和合并症）的信息完整。我们使用逻辑回归来评估吸烟状况和吸烟强度与 COVID-19 严重程度（定义为住院、入住重症监护病房（ICU）或死亡）之间的关联，同时调整了社会人口统计学和合并症因素。
在纳入分析的 4611 名 COVID-19 患者中，18.2%为当前吸烟者，20.7%为前吸烟者。住院、入住 ICU 和死亡的 COVID-19 结局发生率分别为 28.9%、9.8%和 1.4%。在调整后的分析中，当前吸烟（OR：1.23，95%CI：1.02-1.49）、前吸烟（OR：1.28，95%CI：1.07-1.54）和吸烟年包数（OR：1.09，95%CI：1.02-1.17）与住院率较高相关。平均每日吸烟包数与住院率（OR：1.30，95%CI：1.10-1.53）和 ICU 入住率（OR：1.23，95%CI：1.04-1.44）较高相关。
吸烟状况、吸烟年包数和吸烟强度与 COVID-19 患者的住院有关，而吸烟强度与 ICU 入住有关。这些发现强调了在评估 COVID-19 吸烟者时，需要超越吸烟状况提供更详细的信息，以便在高危患者中优化管理潜在的不良后果。
