Obesity and Smoking as Risk Factors for Invasive Mechanical Ventilation in COVID-19 Respiratory Failure: a Retrospective, Observational Cohort Study

Monteiro, Ana Carolina Costa; Suri, Rajat; Emeruwa, I.O.; Stretch, Robert; Cortes-Lopez, Roxana Y; Sherman, Alexander E.; Lindsay, Catherine C; Fulcher, Jennifer A.; Goodman‐Meza, David; Sapru, Anil; Buhr, Russell G.; Chang, Steven Y.; Wang, Tisha; Qadir, Nida

doi:10.1101/2020.08.12.20173849

Cited by 13 publications

(11 citation statements)

References 37 publications

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“…A study in Iran showed that among 193 confirmed COVID-19 patients, more than half of cigarette smokers and 40% of waterpipe smokers reported their COVID-19 symptoms as severe compared to 22% of never-smokers [34]. In a retrospective study, an observational cohort study of 112 in-patient adults, diagnosed with COVID-19, between March 12 and April 16, 2020, in Los Angeles, smoking history along with obesity and elevated inflammatory markers was associated with an increased need for invasive mechanical ventilation in patients with COVID-19 [35]. Another retrospective cohort study, conducted between February 24, 2020 and April 20, 2020 in Kuwait indicated that asthma, smoking and elevated procalcitonin levels correlated significantly with mortality in COVID-19 patients [36].…”

Section: Resultsmentioning

confidence: 99%

Tobacco use as a well-recognized cause of severe COVID-19 manifestations

Gupta

Nethan

Mehrotra

2021

Respiratory Medicine

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Introduction: The Coronavirus disease (COVID-19) infection is caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) primarily affecting the lungs. All tobacco-related illnesses including asthma, chronic obstructive pulmonary disease (COPD), and coronary artery disease are known to reduce the lung capacity and impair the immune system of the body and can greatly influence the ability to fight the novel coronavirus. The purpose of this state-of-the-art literature review is to summarize the evidence of the association of tobacco use with the severity of the COVID-19 manifestations. Method: Articles describing the association of tobacco use with the severity of COVID-19 manifestations were searched on PubMed, MEDLINE, and Google. This review covers the relevant studies on the subject published from January 1, 2020 to September 10, 2020. Results: Tobacco use in all forms, whether smoking or chewing, is significantly associated with severe COVID-19 outcomes. Pre-existing comorbidities in tobacco users such as cardiovascular diseases, diabetes, respiratory diseases and hypertension were found to further aggravate the disease manifestations making the treatment of such COVID-19 patients more challenging due to their rapid clinical deterioration. Conclusions: Current review indicates that nicotine exposure is linked to cardiopulmonary vulnerability to COVID-19 and tobacco use can be a potential risk factor for not only getting the viral infection but also its severe manifestations. The current pandemic provides a teachable moment to break the cycle of nicotine addiction and accelerate national tobacco control programs to achieve a tobacco-free world.

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Section: Resultsmentioning

confidence: 99%

Tobacco use as a well-recognized cause of severe COVID-19 manifestations

Gupta

Nethan

Mehrotra

2021

Respiratory Medicine

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“…The mean age of the patients in the included studies was 54.10 years. Nineteen studies defined outcomes as disease severity 22 , 27 – 30 , 37 – 39 , 42 , 43 , 46 – 50 , 58 , 60 , 62 , 63 . Seventeen studies defined outcomes as death 21 , 33 , 40 , 44 , 45 , 51 – 57 , 59 , 65 – 68 .…”

Section: Resultsmentioning

confidence: 99%

“…All studies defined smoking status as current smoker. Eleven studies included former smokers and current smokers 22 , 33 , 43 , 44 , 47 , 57 , 58 , 61 – 63 , 67 .…”

Section: Resultsmentioning

confidence: 99%

“…The important characteristics and outcomes of the included articles were collated (Table 1). Of 40 articles, 19 were conducted in China 21,22,27,29,30,[37][38][39][40][41][42][43][44][45][46][47][48][49][50] , one in Kuwait 26 , one in Korea 28 , one in Mexico 51 , one in Japan 52 , two in Spain 53,54 , three in Italy [55][56][57] , and twelve in the USA 33,[58][59][60][61][62][63][64][65][66][67][68] . Most articles were retrospective studies.…”

Section: Search Results and Characteristics Of Studies Includedmentioning

confidence: 99%

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Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis

Umnuaypornlert¹,

Kanchanasurakit²,

Lucero‐Prisno³

et al. 2021

Tob. Induc. Dis.

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INTRODUCTION COVID-19 has major effects on the clinical, humanistic and economic outcomes among patients, producing severe symptoms and death. Smoking has been reported as one of the factors that increases severity and mortality rate among COVID-19 patients. However, the effect of smoking on such medical outcomes is still controversial. This study conducted a comprehensive systematic review and meta-analysis (SR/MA) on the association between smoking and negative outcomes among COVID-19 patients. METHODS Electronic databases, including PubMed, EMBASE, Cochrane Library, Science Direct, Google Scholar, were systematically searched from the initiation of the database until 12 December 2020. All relevant studies about smoking and COVID-19 were screened using a set of inclusion and exclusion criteria. The Newcastle–Ottawa Scale was used to assess the methodological quality of eligible articles. Random meta-analyses were conducted to estimate odds ratios (ORs) with 95% confidence interval (CIs). Publication bias was assessed using the funnel plot, Begg’s test and Egger’s test. RESULTS A total of 1248 studies were retrieved and reviewed. A total of 40 studies were finally included for meta-analysis. Both current smoking and former smoking significantly increase the risk of disease severity (OR=1.58; 95% CI: 1.16–2.15, p=0.004; and OR=2.48; 95% CI: 1.64–3.77, p<0.001; respectively) with moderate appearance of heterogeneity. Similarly, current smoking and former smoking also significantly increase the risk of death (OR=1.35; 95% CI: 1.12–1.62, p=0.002; and OR=2.58; 95% CI: 2.15–3.09, p<0.001; respectively) with moderate appearance of heterogeneity. There was no evidence of publication bias, which was tested by the funnel plot, Begg’s test and Egger’s test. CONCLUSIONS Smoking, even current smoking or former smoking, significantly increases the risk of COVID-19 severity and death. Further causational studies on this association and ascertianing the underlying mechanisms of this relation is warranted.

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“…The copyright holder for this preprint this version posted March 11, 2021. ; https://doi.org/10.1101/2021.03.09.21253206 doi: medRxiv preprint themselves are associated with increased pro-inflammatory cytokine levels and may represent independent risk factors for severe COVID-19 (9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Proteome-wide Mendelian randomization identifies causal links between blood proteins and severe COVID-19

Palmos

Millischer

Menon

et al. 2021

Preprint

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The COVID-19 pandemic death toll now surpasses two million individuals and there is a need for early identification of individuals at increased risk of mortality. Host genetic variation partially drives the immune and biochemical responses to COVID-19 that lead to risk of mortality. We identify and prioritise blood proteins and biomarkers that may indicate increased risk for severe COVID-19, via a proteome Mendelian randomization approach by collecting genome-wide association study (GWAS) summary statistics for >4,000 blood proteins. After multiple testing correction, troponin I3, cardiac type (TNNI3) had the strongest effect (odds ratio (O.R.) of 6.86 per standard deviation increase in protein level), with proteinase 3 (PRTN3) (O.R.=2.48), major histocompatibility complex, class II, DQ alpha 2 (HLA-DQA2) (O.R.=2.29), the C4A-C4B heterodimer (O.R.=1.76) and low-density lipoprotein receptor-related protein associated protein 1 (LRPAP1) (O.R.=1.73) also being associated with higher odds of severe COVID-19. Conversely, major histocompatibility complex class I polypeptide-related sequence A (MHC1A) (O.R.=0.6) and natural cytotoxicity triggering receptor 3 (NCR3) (O.R.=0.46) were associated with lower odds. These proteins are involved in heart muscle contraction, natural killer and antigen presenting cells, and the major histocompatibility complex. Based on these findings, it may be possible to better predict which patients may develop severe COVID-19 and to design better treatments targeting the implicated mechanisms.

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Obesity and Smoking as Risk Factors for Invasive Mechanical Ventilation in COVID-19 Respiratory Failure: a Retrospective, Observational Cohort Study

Cited by 13 publications

References 37 publications

Tobacco use as a well-recognized cause of severe COVID-19 manifestations

Tobacco use as a well-recognized cause of severe COVID-19 manifestations

Smoking and risk of negative outcomes among COVID-19 patients: A systematic review and meta-analysis

Proteome-wide Mendelian randomization identifies causal links between blood proteins and severe COVID-19

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