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COVID-19 Disease Course in Former Smokers, Smokers and COPD Patients
Ricardo Wesley Alberca1, Júlia Cataldo Lima1, Emily Araujo de Oliveira1,2
1Laboratorio de Dermatologia e Imunodeficiencias (LIM-56), Departamento de Dermatologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
Insights
Smokers and individuals with chronic obstructive pulmonary disease (COPD) face increased COVID-19 severity. This study found higher inflammatory markers in these groups during illness, confirming smoking and COPD as risk factors for severe coronavirus disease-2019.
Area of Science:
- Medicine
- Pulmonology
- Infectious Diseases
Background:
- Coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, is a global health crisis.
- Risk factors for severe COVID-19 include hypertension, diabetes, obesity, and older age.
- The role of smoking and chronic obstructive pulmonary disease (COPD) in COVID-19 severity remains debated, with previous studies lacking control for comorbidities.
Purpose of the Study:
- To longitudinally evaluate the COVID-19 disease course in smokers, former smokers, and COPD patients without other comorbidities.
- To determine if smoking and COPD are independent risk factors for severe COVID-19.
Main Methods:
- Longitudinal evaluation of hospitalized COVID-19 patients.
- Stratification into groups: smokers, former smokers, and COPD patients, all without other comorbidities.
- Monitoring of disease course from admission to discharge, including inflammatory markers.
Main Results:
- No significant differences were observed between groups upon hospital admission.
- Smokers and COPD patients exhibited increased COVID-19-associated inflammatory markers during their illness compared to non-smokers and former smokers.
- These findings suggest a distinct inflammatory response in smokers and COPD patients with COVID-19.
Conclusions:
- Smoking and COPD are identified as independent risk factors for severe COVID-19.
- The findings have implications for managing the ongoing COVID-19 pandemic, particularly for vulnerable respiratory patient groups.
- Further research into the mechanisms underlying increased inflammation in these populations is warranted.
Abstract:
The severe respiratory and systemic disease named coronavirus disease-2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, the COVID-19 pandemic presents a huge social and health challenge worldwide. Many different risk factors are associated with disease severity, such as systemic arterial hypertension, diabetes mellitus, obesity, older age, and other co-infections. Other respiratory diseases such as chronic obstructive pulmonary disease (COPD) and smoking are common comorbidities worldwide. Previous investigations have identified among COVID-19 patients smokers and COPD patients, but recent investigations have questioned the higher risk among these populations. Nevertheless, previous reports failed to isolate smokers and COPD patients without other comorbidities. We performed a longitudinal evaluation of the disease course of smokers, former smokers, and COPD patients with COVID-19 without other comorbidities, from hospitalization to hospital discharge. Although no difference between groups was observed during hospital admission, smokers and COPD patients presented an increase in COVID-19-associated inflammatory markers during the disease course in comparison to non-smokers and former smokers. Our results demonstrated that smoking and COPD are risk factors for severe COVID-19 with possible implications for the ongoing pandemic.
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