Impact of smoking on COVID-19 outcomes: a HOPE Registry subanalysis. Issue 1 (17th June 2021)

• Record Type: Journal Article
• Authors: Espejo-Paeres, Carolina; Núñez-Gil, Iván J; Estrada, Vicente; Fernández-Pérez, Cristina; Uribe-Heredia, Giovanna; Cabré-Verdiell, Clara; Uribarri, Aitor; Romero, Rodolfo; García-Aguado, Marcos; Fernández-Rozas, Inmaculada; Becerra-Muñoz, Victor; Pepe, Martino; Cerrato, Enrico; Raposeiras-Roubín, Sergio; Barrionuevo-Ramos, María; Aveiga-Ligua, Freddy; Aguilar-Andrea, Carolina; Alfonso-Rodríguez, Emilio; Ugo, Fabrizio; García-Prieto, Juan Fortunato; Feltes, Gisela; Akin, Ibrahim; Huang, Jia; Jativa, Jorge; Fernández-Ortiz, Antonio; Macaya, Carlos; Carrero-Fernández, Ana; Signes-Costa, Jaime
• Is Part Of: BMJ nutrition, prevention & health. Volume 4:Issue 1(2021)
• Page Start: 285
• Page End: 292
• Publication Date: 2021-06-17
• Subjects: COVID-19 -- infectious disease -- pulmonary disease; Nutrition -- Periodicals; Health behavior -- Periodicals; Lifestyles -- Periodicals; 613
• DOI: 10.1136/bmjnph-2021-000269
• Languages: English
• ISSNs: 2516-5542

Abstract

Abstract : Background: Smoking has been associated with poorer outcomes in relation to COVID-19. Smokers have higher risk of mortality and have a more severe clinical course. There is paucity of data available on this issue, and a definitive link between smoking and COVID-19 prognosis has yet to be established. Methods: We included 5224 patients with COVID-19 with an available smoking history in a multicentre international registry Health Outcome Predictive Evaluation for COVID-19 (NCT04334291 ). Patients were included following an in-hospital admission with a COVID-19 diagnosis. We analysed the outcomes of patients with a current or prior history of smoking compared with the non-smoking group. The primary endpoint was all-cause in-hospital death. Results: Finally, 5224 patients with COVID-19 with available smoking status were analysed. A total of 3983 (67.9%) patients were non-smokers, 934 (15.9%) were former smokers and 307 (5.2%) were active smokers. The median age was 66 years (IQR 52.0–77.0) and 58.6% were male. The most frequent comorbidities were hypertension (48.5%) and dyslipidaemia (33.0%). A relevant lung disease was present in 19.4%. In-hospital complications such sepsis (23.6%) and embolic events (4.3%) occurred more frequently in the smoker group (p<0.001 for both). All cause-death was higher among smokers (active or former smokers) compared with non-smokers (27.6 vs 18.4%, p<0.001). Following a multivariate analysis, current smoking was considered as an independent predictor of mortality (OR 1.77, 95% CI 1.11 to 2.82, p=0.017) and a combined endpoint of severe disease (OR 1.68, 95% CI 1.16 to 2.43, p=0.006). Conclusion: Smoking has a negative prognostic impact on patients hospitalised with COVID-19.