Cross-sectional analysis of tobacco addiction in hospitalized COVID-19 patients

The COVID-19 pandemic has become an important health issue with consequences for special populations since 2019. Tobacco use is an important public health issue and tobacco users are a risk group for lung infections.

The aim of this study is to obtain information about disease prevalence and severity, laboratory parameters, and changes in radiological findings between smokers and non-smokers who were hospitalized, followed up, and treated for COVID-19, and to find answers to critical questions regarding the response to antiviral and supportive therapy. Two hundred eighty-six patients who were hospitalized and treated between March 2020-February 2021 in the COVID-19 Isolation Ward of Başkent University Hospital were included in the study. The patients were grouped as current smokers, non-smokers, and ex-smokers. The groups were compared in terms of symptoms, laboratory findings, radiological findings, and treatment response.

The median age of the patients included in the study was 59 (IQR= 32). Of the patients, 40.6% were female and 59.4% were male. In our study, we discovered that there were fewer female smokers (p<0.001). When the current smokers (n= 56), non-smokers (n= 159), and ex-smokers (n= 71) were compared based on their findings, it was found that dyspnea was more common in current smokers (p= 0.009). Lung involvement was found to be more common (p= 0.002) and multifocal in the current smokers group (p= 0.038). The levels of oxygen saturation at the times of admission and discharge were lower in current smokers (p= 0.002 and p= 0.038). The need for nasal oxygen and noninvasive mechanical ventilation was also found to be higher in current smokers (p= 0.008 and p= 0.039). Systemic steroid requirement was higher in current smokers (p= 0.013). There was no statistically significant difference in terms of mortality between current smokers, ex-smokers, and non-smokers (p= 0.662).

The analysis of the findings of the patients hospitalized in the COVID-19 isolation ward indicated that COVID-19 leads to a more serious course in patients with a history of smoking.