Publication: Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: a systematic review and meta-analysis
Issued Date
2021-12-01
Resource Type
ISSN
14712458
Other identifier(s)
2-s2.0-85112503119
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Mahidol University
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SCOPUS
Bibliographic Citation
BMC Public Health. Vol.21, No.1 (2021)
Suggested Citation
Roengrudee Patanavanich, Stanton A. Glantz Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: a systematic review and meta-analysis. BMC Public Health. Vol.21, No.1 (2021). doi:10.1186/s12889-021-11579-x Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/77549
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Title
Smoking is associated with worse outcomes of COVID-19 particularly among younger adults: a systematic review and meta-analysis
Author(s)
Abstract
Background: Smoking impairs lung immune function and damages upper airways, increasing risks of contracting and severity of infectious diseases. This paper quantifies the association between smoking and COVID-19 disease progression. Methods: We searched PubMed and Embase for studies published from January 1–May 25, 2020. We included studies reporting smoking behavior of COVID-19 patients and progression of disease, including death. We used random effects meta-analysis, meta-regression and locally weighted regression and smoothing to examine relationships in the data. Results: We identified 46 peer-reviewed papers with a total of 22,939 COVID-19 patients, 5421 (23.6%) experienced disease progression and 2914 (12.7%) with a history of smoking (current and former smokers). Among those with a history of smoking, 33.5% experienced disease progression, compared with 21.9% of non-smokers. The meta-analysis confirmed an association between ever smoking and COVID-19 progression (OR 1.59, 95% CI 1.33–1.89, p = 0.001). Ever smoking was associated with increased risk of death from COVID-19 (OR 1.19, 95% CI 1.02–1.39, p = 0.003). We found no significant difference (p = 0.864) between the effects of ever smoking on COVID-19 disease progression between adjusted and unadjusted analyses, suggesting that smoking is an independent risk factor for COVID-19 disease progression. We also found the risk of having COVID-19 progression higher among younger adults (p = 0.001), with the effect most pronounced among younger adults under about 45 years old. Conclusions: Smoking is an independent risk for having progression of COVID-19, including mortality. The effects seem to be higher among young people. Smoking prevention and cessation should remain a priority for the public, physicians, and public health professionals during the COVID-19 pandemic.