Rajai Firouzabadi Shahryar, Mohammadi Ida, Alinejadfard Mohammadreza, Shafiee Arman
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Alborz University of Medical Science, Karaj, Iran.
Sci Rep. 2025 Jan 22;15(1):2870. doi: 10.1038/s41598-025-87354-4.
The COVID-19 pandemic has resulted in many survivors experiencing post-acute COVID-19 syndrome (PCS) with symptoms including fatigue, breathlessness, and cognitive complaints. E-cigarette use has already been associated with increased susceptibility to COVID-19 because of its effects on ACE2 receptor expression and inflammation, raising concern that it might worsen the long-term outcomes of COVID-19, including PCS. While traditional smoking is associated with a higher risk of PCS, the role of e-cigarettes remains unclear due to conflicting evidence. Using 2022 Behavioral Risk Factor Surveillance System (BRFSS) data, this study investigated the association between e-cigarette use and PCS among US adults who tested positive for COVID-19. The final sample included 107,249 adults after the exclusion of respondents with missing information. It analyzed e-cigarette use (never, former, current) and controlled for key covariates such as age, gender, BMI, smoking, and chronic diseases. The results showed that female gender, obesity, current smoking, and a history of depression, asthma, and chronic obstructive pulmonary disease (COPD) were significantly associated with higher odds of PCS. Nevertheless, e-cigarette use was not related significantly to increased odds for PCS (current e-cigarette use: aOR = 1.07, 95 CI: 0.96, 1.20; former e-cigarette use: aOR = 1.03, 95 CI: 0.96, 1.12). The mediation analysis showed no indirect effect of the use of e-cigarettes on PCS via COPD. In conclusion our findings did not reveal an independent or indirect association between PCS with e-cigarette use.
新冠疫情导致许多幸存者出现新冠后急性综合征（PCS），症状包括疲劳、呼吸急促和认知方面的不适。由于电子烟会影响血管紧张素转换酶2（ACE2）受体表达和引发炎症，其使用已被认为与感染新冠的易感性增加有关，这引发了人们对电子烟可能会使包括PCS在内的新冠长期后果恶化的担忧。虽然传统吸烟与患PCS的风险较高有关，但由于证据相互矛盾，电子烟的作用仍不明确。本研究利用2022年行为风险因素监测系统（BRFSS）的数据，调查了新冠检测呈阳性的美国成年人中电子烟使用与PCS之间的关联。在排除信息缺失的受访者后，最终样本包括107249名成年人。该研究分析了电子烟使用情况（从不使用、曾经使用、当前使用），并对年龄、性别、体重指数、吸烟情况和慢性病等关键协变量进行了控制。结果显示，女性、肥胖、当前吸烟以及有抑郁症、哮喘和慢性阻塞性肺疾病（COPD）病史与患PCS的几率显著较高有关。然而，电子烟使用与患PCS几率增加并无显著关联（当前使用电子烟：调整后比值比[aOR]=1.07，95%置信区间[CI]：0.96，1.20；曾经使用电子烟：aOR=1.03，95%CI：0.96，1.12）。中介分析表明，电子烟使用通过COPD对PCS没有间接影响。总之，我们的研究结果并未揭示PCS与电子烟使用之间存在独立或间接关联。
