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Nicotine dependence among critically ill COVID-19 patients: A population-based cohort study
John Garza1, Roy Sebastian1, Brinkley Cover1
1Texas Tech University Health Sciences Center at the Permian Basin, Odessa, Texas, United States of America.
Nicotine dependence may reduce mortality risk in hospitalized COVID-19 patients. Current and former nicotine users showed lower in-hospital mortality rates compared to non-users, warranting further investigation.
Area of Science:
- Public Health
- Epidemiology
- Clinical Medicine
Background:
- Nicotine dependence is linked to poor health outcomes and respiratory diseases.
- The prognostic impact of nicotine dependence on COVID-19 outcomes remains unclear.
Purpose of the Study:
- To investigate the association between nicotine dependence and mortality in intensive care unit (ICU) patients diagnosed with COVID-19.
Main Methods:
- Analysis of deidentified Texas ICU hospitalization records (Q2 2020-Q4 2024) for patients aged ≥18 with COVID-19.
- Categorization of patients into current, former, and never nicotine dependent groups.
- Weighted multivariable logistic regression and g-computation to assess nicotine dependence's effect on mortality.
Main Results:
- 142,045 COVID-19 ICU hospitalizations were analyzed; 7.3% were current, 16.7% former, and 76.0% never nicotine dependent.
- Nicotine-dependent individuals had a higher comorbidity burden but lower in-hospital mortality rates (10.7% current, 13.8% former vs. 16.1% never).
- Adjusted analyses confirmed that current and former nicotine dependence were associated with reduced in-hospital and short-term mortality.
Conclusions:
- Current and former nicotine dependence were associated with lower mortality among hospitalized COVID-19 patients, despite higher comorbidity burdens.
- These findings suggest a potential protective effect of nicotine dependence against COVID-19 mortality.
- Further research is needed to elucidate the underlying mechanisms driving these observations.
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