Burnett-Hartman Andrea N, Goldberg Scott Shauna, Powers J David, Clennin Morgan N, Lyons Jason A, Gray Mark, Feigelson Heather Spencer
Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
Tob Use Insights. 2022 Apr 24;15:1179173X221096638. doi: 10.1177/1179173X221096638. eCollection 2022.
Although combustible cigarette use is an established risk factor for severe COVID-19 disease, there is conflicting evidence for the association of electronic cigarette use with SARS-CoV-2 infection and COVID-19 disease severity.
Study participants were from the Kaiser Permanente Research Bank (KPRB), a biorepository that includes adult Kaiser Permanente members from across the United States. Starting in April 2020, electronic surveys were sent to KPRB members to assess the impact of the COVID-19 pandemic. These surveys collected information on self-report of SARS-CoV-2 infection and COVID-related risk factors, including electronic cigarette and combustible cigarette smoking history. We also used electronic health records data to assess COVID-19 diagnoses, positive PCR lab tests, hospitalizations, and death. We used multivariable Cox proportional hazards regression to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) comparing the risk of SARS-CoV-2 infection between individuals by e-cigarette use categories (never, former, and current). Among those with SARS-CoV-2 infection, we used multivariable logistic regression to estimate adjusted odds ratios (ORs) and 95% CIs comparing the odds of hospitalization or death within 30 days of infection between individuals by e-cigarette use categories.
There were 126,475 individuals who responded to the survey and completed questions on e-cigarette and combustible cigarette use (48% response rate). Among survey respondents, 819 (1%) currently used e-cigarettes, 3,691 (3%) formerly used e-cigarettes, and 121,965 (96%) had never used e-cigarettes. After adjustment for demographic, behavioral, and clinical factors, there was no association with SARS-CoV-2 infection and former e-cigarette use (hazard ratio (HR) = 0.99; CI: 0.83-1.18) or current e-cigarette use (HR = 1.08; CI: 0.76-1.52). Among those with SARS-CoV-2 infection, there was no association with hospitalization or death within 30 days of infection and former e-cigarette use (odds ratio (OR) = 1.19; CI: 0.59-2.43) or current e-cigarette use (OR = 1.02; CI: 0.22-4.74).
Our results suggest that e-cigarette use is not associated with an increased risk of SARS-CoV-2 infection or severe COVID-19 illness.
尽管吸食可燃香烟是严重 COVID-19 疾病的既定风险因素，但关于吸食电子烟与 SARS-CoV-2 感染及 COVID-19 疾病严重程度之间的关联，证据存在冲突。
研究参与者来自凯撒永久医疗研究库（KPRB），这是一个生物样本库，包含来自美国各地的成年凯撒永久医疗会员。从 2020 年 4 月开始，向 KPRB 会员发送电子调查问卷，以评估 COVID-19 大流行的影响。这些调查收集了关于 SARS-CoV-2 感染的自我报告以及与 COVID 相关的风险因素信息，包括电子烟和可燃香烟吸烟史。我们还使用电子健康记录数据来评估 COVID-19 诊断、PCR 实验室检测阳性、住院情况和死亡情况。我们使用多变量 Cox 比例风险回归来计算调整后的风险比（HR）和 95%置信区间（CI），比较按电子烟使用类别（从不、曾经和当前）划分的个体之间 SARS-CoV-2 感染的风险。在感染 SARS-CoV-2 的人群中，我们使用多变量逻辑回归来估计调整后的比值比（OR）和 95%CI，比较按电子烟使用类别划分的个体在感染后 30 天内住院或死亡的几率。
有 126,475 人回复了调查问卷并完成了关于电子烟和可燃香烟使用的问题（回复率为 48%）。在调查受访者中，819 人（1%）当前使用电子烟，3,691 人（3%）曾经使用电子烟，121,
