Jiménez-Ruiz Carlos A, López-Padilla Daniel, Alonso-Arroyo Adolfo, Aleixandre-Benavent Rafael, Solano-Reina Segismundo, de Granda-Orive José Ignacio
Unidad Especializada de Tabaquismo de la Comunidad de Madrid, Madrid, España.
Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Arch Bronconeumol. 2021 Jan;57:21-34. doi: 10.1016/j.arbres.2020.06.024. Epub 2020 Jul 25.
The aim of this study was to determine if tobacco use in patients with Covid-19 is associated with a negative disease course and adverse outcome, and if smoking, current and past, is associated with a greater possibility of developing COVID-19.
A systematic review (SR) and meta-analysis (MA) of previously published works were performed. The search strategy included all known descriptors for Covid-19 and tobacco and was conducted in different databases. Appropriate statistical models were used to address the effect size in meta-analysis, namely random effects and fixed effects model.
Thirty-four articles were identified in the SR of which 19 were included in the MA. Being a smoker or former smoker was shown to be a risk factor for worse progression of Covid-19 infection (OR 1.96, 95% CI, 1.36 - 2.83) and a greater probability of presenting a more critical condition (OR 1.79 95% CI, 1.19 - 2.70). As limitations of the MA, we found that most of the studies analyzed were observational with limited publication bias. Two studies that disagreed with the rest were included, although after withdrawing them from the MA, smoking was maintained as a risk factor for worse progress.
Current and past smoking produces a more serious clinical form of Covid-19 and more frequently leads to intensive care admission, intubation, and death.
本研究旨在确定新冠病毒病（Covid-19）患者的烟草使用是否与不良病程和不良结局相关，以及当前和既往吸烟是否与感染新冠病毒病（COVID-19）的更大可能性相关。
对先前发表的研究进行系统评价（SR）和荟萃分析（MA）。检索策略包括所有已知的关于新冠病毒病和烟草的描述词，并在不同数据库中进行检索。在荟萃分析中使用适当的统计模型来处理效应量，即随机效应模型和固定效应模型。
在系统评价中识别出34篇文章，其中19篇纳入荟萃分析。结果显示，吸烟者或既往吸烟者是新冠病毒病感染进展更差的危险因素（比值比1.96，95%置信区间，1.36 - 2.83），且出现更严重病情的可能性更大（比值比1.79，95%置信区间，1.19 - 2.70）。作为荟萃分析的局限性，我们发现大多数分析的研究是观察性的，发表偏倚有限。纳入了两项与其他研究结果不一致的研究，尽管将它们从荟萃分析中剔除后，吸烟仍然是病情进展更差的危险因素。
当前和既往吸烟会导致新冠病毒病更严重的临床症状，并且更频繁地导致入住重症监护病房、插管和死亡。
