Influence of smoking history on the evolution of hospitalized in COVID-19 positive patients: results from the SEMI-COVID-19 registry

• Published in: Medicina clinica Vol. 159; no. 5; p. 214
• Main Authors: Navas Alcántara, María Sierra, Montero Rivas, Lorena, Guisado Espartero, María Esther, Rubio-Rivas, Manuel, Ayuso García, Blanca, Moreno Martinez, Francisco, Ausín García, Cristina, Taboada Martínez, María Luisa, Arnalich Fernández, Francisco, Martínez Murgui, Raúl, Molinos Castro, Sonia, Ramos Muñoz, Maria Esther, Fernández-Garcés, Mar, Carreño Hernandez, Mari Cruz, García García, Gema María, Vázquez Piqueras, Nuria, Abadía-Otero, Jesica, Lajara Villar, Lourdes, Salazar Monteiro, Cristina, Pascual Pérez, María de Los Reyes, Perez-Martin, Santiago, Collado-Aliaga, Javier, Antón-Santos, Juan-Miguel, Lumbreras-Bermejo, Carlos
• Format: Journal Article
• Language: English
• Published: Spain 09.09.2022
• Subjects: Aged; COVID-19 - epidemiology; Hospitalization; Humans; Intensive Care Units; Male; Registries; Retrospective Studies; SARS-CoV-2; COVID-19; Tabaquismo; Hospitalizado; SARS-CoV-2; Mortality; Mortalidad; Hospitalized; Smoking
• ISSN: 1578-8989
• DOI: 10.1016/j.medcli.2021.10.011

Smoking can play a key role in SARS-CoV-2 infection and in the course of the disease. Previous studies have conflicting or inconclusive results on the prevalence of smoking and the severity of the coronavirus disease (COVID-19). Observational, multicenter, retrospective cohort study of 14,260 patients admitted for COVID-19 in Spanish hospitals between February and September 2020. Their clinical characteristics were recorded and the patients were classified into a smoking group (active or former smokers) or a non-smoking group (never smokers). The patients were followed up to one month after discharge. Differences between groups were analyzed. A multivariate logistic regression and Kapplan Meier curves analyzed the relationship between smoking and in-hospital mortality. The median age was 68.6 (55.8-79.1) years, with 57.7% of males. Smoking patients were older (69.9 [59.6-78.0 years]), more frequently male (80.3%) and with higher Charlson index (4 [2-6]) than non-smoking patients. Smoking patients presented a worse evolution, with a higher rate of admission to the intensive care unit (ICU) (10.4 vs 8.1%), higher in-hospital mortality (22.5 vs. 16.4%) and readmission at one month (5.8 vs. 4.0%) than in non-smoking patients. After multivariate analysis, smoking remained associated with these events. Active or past smoking is an independent predictor of poor prognosis in patients with COVID-19. It is associated with higher ICU admissions and in-hospital mortality.