Impact of accumulative smoking exposure and chronic obstructive pulmonary disease on COVID-19 outcomes: report based on findings from the Japan COVID-19 task force. (March 2023)

• Record Type: Journal Article
• Authors: Watase, Mayuko; Masaki, Katsunori; Chubachi, Shotaro; Namkoong, Ho; Tanaka, Hiromu; Lee, Ho; Fukushima, Takahiro; Otake, Shiro; Nakagawara, Kensuke; Kusumoto, Tatsuya; Asakura, Takanori; Kamata, Hirofumi; Ishii, Makoto; Hasegawa, Naoki; Oyamada, Yoshitaka; Harada, Norihiro; Ueda, Tetsuya; Ueda, Soichiro; Ishiguro, Takashi; Arimura, Ken; Saito, Fukuki; Yoshiyama, Takashi; Nakano, Yasushi; Mutoh, Yoshikazu; Suzuki, Yusuke; Edahiro, Ryuya; Sano, Hirohito; Sato, Yasunori; Okada, Yukinori; Koike, Ryuji; Kitagawa, Yuko; Tokunaga, Katsushi; Kimura, Akinori; Imoto, Seiya; Miyano, Satoru; Ogawa, Seishi; Kanai, Takanori; Fukunaga, Koichi;
• Is Part Of: International journal of infectious diseases. Volume 128(2023)
• Page Start: 121
• Page End: 127
• Publication Date: 2023-03
• Subjects: Smoking -- COVID-19 -- COPD -- Invasive mechanical ventilation; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.12.019
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Smoking and chronic obstructive pulmonary disease are known risk factors of severe COVID-19. Cumulative smoking exposure was positively associated with COVID-19 outcomes. In patients aged <65 years, chronic obstructive pulmonary disease affected disease severity in those with >30 pack-years. Abstract: Objectives: Smoking and chronic obstructive pulmonary disease (COPD) are risk factors for severe COVID-19. However, limited literature exists on the effect of COPD and smoking on COVID-19 outcomes. This study examined the impact of smoking exposure in pack-years (PY) and COPD on COVID-19 outcomes among smokers in Japan. Methods: The study included 1266 smokers enrolled by the Japan COVID-19 task force between February 2020 and December 2021. PY and COPD status was self-reported by patients. Patients were classified into the non-COPD (n = 1151) and COPD (n = 115) groups; the non-COPD group was further classified into <10 PY (n = 293), 10-30 PY (n = 497), and >30 PY (n = 361). The study outcome was the need for invasive mechanical ventilation (IMV). Results: The incidence of IMV increased with increasing PY and was highest in the COPD group (<10 PY = 7.8%, 10-30 PY = 12.3%, >30 PY = 15.2%, COPD = 26.1%; P <0.001). A significant association was found for IMV requirement in the >30 PY and COPD groups through univariate (odds ratio [OR]: >30 PY = 2.11, COPD = 4.14) and multivariate (OR: >30 PY = 2.38; COPD = 7.94) analyses. Increasing PY number was also associated with increased IMV requirement in patients aged <65 years. Conclusion: Cumulative smoking exposure was positively associated with COVID-19 outcomes in smokers.