Tobacco smoking confers risk for severe COVID‐19 unexplainable by pulmonary imaging

Abstract

Background COVID‐19 is a new pneumonia. It has been hypothesized that tobacco smoking history may increase severity of this disease in the patients once infected by the underlying coronavirus SARS‐CoV‐2 because smoking and COVID‐19 both cause lung damage. However, this hypothesis has not been tested. Objective Current study was designed to focus on smoking history in patients with COVID‐19 and test this hypothesis that tobacco smoking history increases risk for severe COVID‐19 by damaging the lungs. Methods and results This was a single‐site, retrospective case series study of clinical associations, between epidemiological findings and clinical manifestations, radiographical or laboratory results. In our well‐characterized cohort of 954 patients including 56 with tobacco smoking history, smoking history increased the risk for severe COVID‐19 with an odds ratio (OR) of 5.5 (95% CI: 3.1–9.9; P = 7.3 × 10 −8 ). Meta‐analysis of ten cohorts for 2891 patients together obtained an OR of 2.5 (95% CI: 1.9–3.3; P < 0.00001). Semi‐quantitative analysis of lung images for each of five lobes revealed a significant difference in neither lung damage at first examination nor dynamics of the lung damage at different time‐points of examinations between the smoking and nonsmoking groups. No significant differences were found either in laboratory results including D‐dimer and C‐reactive protein levels except different covariances for density of the immune cells lymphocyte ( P = 3.8 × 10 −64 ) and neutrophil ( P = 3.9 × 10 −46 ). Conclusion Tobacco smoking history increases the risk for great severity of COVID‐19 but this risk is achieved unlikely by affecting the lungs.

Substance, use in relation to COVID-19: A scoping review

“…Kumar et al, 2020 (2) The online vaping environment may be affected by the pandemic. [160] A 1% increase in weighted proportion of vapers in each state was associated with a 0.31 increase in the number of COVID-19 cases. Monteiro et al, 2020 Former and current smoking status were associated with invasive mechanical ventilation due to COVID-19.…”

The unfavorable clinical outcome of COVID-19 in smokers is mediated by H3K4me3, H3K9me3 and H3K27me3 histone marks

“…On the basis of the results of a 2021 meta-analysis on more than 800,000 COVID-19 patients, smoking predicts a 19% increased risk of death in patients with COVID-19 [ 2 ]. Strangely enough, this increased severity does not manifest in the form of gross pulmonary damage that is typically revealed by imaging techniques [ 3 ]. Although in the absence of overt gross pathology, it would be sensible to assume smoking-related chronic obstructive pulmonary disease (COPD) as the major culprit behind the worse clinical outcome of COVID-19 in smokers, rather than the adverse effects of smoking itself [ 1 ], one should not overlook the fact that less than one-third of smokers develop COPD [ 4 ].…”

Faktor-Faktor yang Berhubungan dengan Kejadian Coronavirus Disease 2019 (COVID-19) di Provinsi Jawa Tengah

“…10,11 Selain itu, pandemi COVID-19 juga mempengaruhi kesehatan mental dimana kebijakan pemerintah dalam menanggulangi COVID-19 seperti physical distancing dan pembatasan sosial berskala besar (PSBB) bagi sebagian orang menimbulkan dampak negatif seperti cemas, tertekan, hingga stress. [12][13][14] Indonesia merupakan salah satu negara yang terinfeksi COVID-19. Kasus ini menyebar ke seluruh provinsi di Indonesia, termasuk Provinsi Jawa Tengah.…”

“…Asap rokok mampu mengurangi sistem pertahanan alami sehingga virus menjadi lebih mudah menyerang tubuh. 13 Hal ini sesuai dengan hasil penelitian Zhao et al yang menunjukkan hubungan yang signifikan antara merokok dengan kejadian COVID-19 (OR= 2.00, 95% CI 1.3-3.1). 14 Faktor lain yang berhubungan dengan kejadian COVID-19 adalah perilaku konsumsi alkohol.…”

“…Rokok memiliki kandungan kimia seperti hidrogen sianida (HCN). 13,31 Jika zat tersebut masuk ke dalam sistem pernafasan dalam jumlah yang banyak dapat mengakibatkan kerusakan jalur pernafasan yang juga berfungsi sebagai sistem pertahanan tubuh dari benda asing, seperti virus dan bakteri. 13,31 Hal tersebut kemudian dapat mengakibatkan penderita mengalami nafas pendek dan harus menggunakan ventilator.…”