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一项确定吸烟者中新冠病毒疾病严重程度的分析研究。

An Analytical Study to Determine the Severity of COVID-19 Among Smokers.

作者信息

Kanakaraju Kirubhakaran, Vanoli Harshavarthanan, Rajenthrakumar Hamsavardhini, Asokan Arunkumar, Ranganathan Rangabashyam Seetharaman

机构信息

General Medicine, Vinayaka Mission Kirupananda Variyar Medical College and Hospital, Salem, IND.

出版信息

Cureus. 2022 Apr 4;14(4):e23802. doi: 10.7759/cureus.23802. eCollection 2022 Apr.

Abstract

Introduction In December of the year 2020, the SARS-CoV-2 virus was discovered in Wuhan, China. It extended to over 180 nations around the world. It can manifest in patients who are asymptomatic to those who are symptomatic, with symptoms ranging from anosmia to severe respiratory distress syndrome. It affects both men and women. The existence of comorbidity is also linked to a significant worsening of the infection. Despite the fact that the principal consequences of coronavirus disease 2019 (COVID-19) damage the lungs, the prevalence of current smokers among COVID-19 hospitalized patients has repeatedly been observed to be lower than the prevalence of smokers in the general community. As a result, the evidence from various studies appears to cast doubt on active smoking as a risk factor for COVID-19 pneumonia. Thus, with this background, this study has been conducted with the aim of assessing the influence of smoking as a risk factor for COVID-19 mortality. Methodology An observational study was conducted in a tertiary care center in Tamil Nadu for a period of three months (April 2021 to June 2021). The study participants were all the patients admitted to the COVID-19 ward of the department of general medicine during the study period. Those who were not willing to participate in the study were excluded. The questionnaire contains variables including socio-demographic characteristics, vitals, and investigations, and the outcome variable was death due to COVID-19. The data obtained were entered in Microsoft Excel (Microsoft Corporation, Redmond, WA) and the results were analyzed using SPSS version 21 (IBM Corp., Armonk, NY). Results About 401 individuals participated in the study. The mean age, COVID-19 Reporting and Data System (CO-RADS) score, and CT severity score of the study participants were 50 years, 4.91, and 10.61, respectively. About 63.3% of participants were males, about 92% have not been vaccinated, about 91.8% have a CO-RADS score of 5, about 45.1% were smokers, and about 15.7% have died despite effective treatment. When looking for adverse outcomes, being male (p = 0.047), non-vaccinated for COVID-19 (p = 0.042), and being a smoker (p = 0.008) were the factors that showed statistical significance. Conclusion The mortality due to COVID-19 is high among smokers than non-smokers with statistical significance. Thus, before admitting COVID-19 patients, to classify the patients as mild, moderate, and severe, the risk factor of the habit of smoking can be added. Cigarette smoke is harmful to the lungs in a variety of ways, and further research is needed to understand why there is such a low proportion of current smokers among COVID-19 patients in hospitals. The impact of current smoking on SARS-CoV-2 infection is a delicate and complex topic that should be thoroughly investigated before sending out potentially misunderstood signals.

摘要

引言 2020年12月,严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)病毒在中国武汉被发现。它蔓延至全球180多个国家。它可在无症状患者和有症状患者中出现,症状从嗅觉丧失到严重呼吸窘迫综合征不等。它对男性和女性均有影响。合并症的存在也与感染的显著恶化有关。尽管2019冠状病毒病(COVID-19)的主要后果是损害肺部,但在COVID-19住院患者中,目前吸烟者的比例反复被观察到低于普通人群中的吸烟者比例。因此,来自各种研究的证据似乎对主动吸烟作为COVID-19肺炎的危险因素提出了质疑。因此,在此背景下,本研究旨在评估吸烟作为COVID-19死亡危险因素的影响。

方法 在泰米尔纳德邦的一家三级护理中心进行了一项为期三个月(2021年4月至2021年6月)的观察性研究。研究参与者为研究期间入住普通内科COVID-19病房的所有患者。不愿意参与研究的患者被排除。问卷包含社会人口统计学特征、生命体征和检查等变量,结局变量为因COVID-19死亡。将获得的数据录入微软Excel(微软公司,华盛顿州雷德蒙德),并使用SPSS 21版(IBM公司,纽约州阿蒙克)进行结果分析。

结果 约401人参与了该研究。研究参与者的平均年龄、COVID-19报告和数据系统(CO-RADS)评分以及CT严重程度评分分别为50岁、4.91和10.61。约63.3%的参与者为男性,约92%未接种疫苗,约91.8%的CO-RADS评分为5,约45.1%为吸烟者,约15.7%尽管接受了有效治疗仍死亡。在寻找不良结局时,男性(p = 0.047)、未接种COVID-19疫苗(p = 0.042)和吸烟者(p = 0.008)是具有统计学意义的因素。

结论 吸烟者因COVID-19导致的死亡率高于非吸烟者,具有统计学意义。因此,在收治COVID-19患者之前,为了将患者分为轻度、中度和重度,可以增加吸烟习惯这一危险因素。香烟烟雾以多种方式对肺部有害,需要进一步研究以了解为何医院中COVID-19患者中目前吸烟者的比例如此之低。目前吸烟对SARS-CoV-2感染的影响是一个微妙而复杂的话题,在发出可能被误解的信号之前应进行深入调查。

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