COVID-19 and smoking: More severity and death – An experience from Iran

BACKGROUND: Few studies have shown that smokers are more likely than nonsmokers to contract COVID-19, while others report that smokers are underrepresented among those requiring hospital treatment for this illness. This study was designed and implemented for investigating the severity and outcome of COVID-19 based on underlying smoking status. MATERIALS AND METHODS: This was a case–control study that was implemented in Tehran and Ahvaz with all COVID-19 patients from February to July 2020. Patients were divided into two groups of COVID-19 positive (1044 cases) and negative (1231 controls) randomly based on entrance number. RESULTS: The frequency of smokers in the case group is significantly lower than the control group (15.4% vs. 28%). However, the number of days of hospitalization and the use of more than 3 medications in the group of smokers were significantly higher. A comparison between groups of case and control based on smoking indicates that the death rate was significantly higher in smokers with COVID-19. CONCLUSIONS: The results of this study showed that although the number of smokers in COVID-19 patients is significantly lower, smokers run an aggresive curse and have higher mortality.