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Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity

Objective: Smoking status does not indicate the amount or length of tobacco use, and thus, it is an imperfect measure to assess the association between cigarette smoking and severe coronavirus disease 2019 (COVID-19) outcomes. This investigation assessed whether cigarette smoking status, intensity o...

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Autores principales: Mahabee-Gittens, E. Melinda, Mendy, Angelico, Merianos, Ashley L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431679/
https://www.ncbi.nlm.nih.gov/pubmed/34501529
http://dx.doi.org/10.3390/ijerph18178939
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author Mahabee-Gittens, E. Melinda
Mendy, Angelico
Merianos, Ashley L.
author_facet Mahabee-Gittens, E. Melinda
Mendy, Angelico
Merianos, Ashley L.
author_sort Mahabee-Gittens, E. Melinda
collection PubMed
description Objective: Smoking status does not indicate the amount or length of tobacco use, and thus, it is an imperfect measure to assess the association between cigarette smoking and severe coronavirus disease 2019 (COVID-19) outcomes. This investigation assessed whether cigarette smoking status, intensity of smoking (i.e., average daily packs of cigarettes smoked), duration of smoking, and pack-years of smoking are associated with severe outcomes among adults diagnosed with COVID-19. Methods: We conducted a retrospective, cross-sectional study in which we identified consecutive patients diagnosed with COVID-19 at the University of Cincinnati healthcare system between 13 March 2020 and 30 September 2020 who had complete information on smoking status, severe COVID-19 outcomes, and covariates (i.e., demographics and comorbidities). We used logistic regression to evaluate the associations of smoking status and intensity of smoking with COVID-19 severity, defined as hospitalization, admission to intensive care unit (ICU), or death, adjusting for sociodemographics and comorbidities. Results: Among the 4611 COVID-19 patients included in the analysis, 18.2% were current smokers and 20.7% were former smokers. The prevalence of COVID-19 outcomes was 28.9% for hospitalization, 9.8% for ICU admission, and 1.4% for death. In the adjusted analysis, current smoking (AOR: 1.23, 95% CI: 1.02–1.49), former smoking (AOR: 1.28, 95% CI: 1.07–1.54), and pack-years of smoking (AOR: 1.09, 95% CI: 1.02–1.17) were associated with a higher prevalence of hospitalization. Average daily packs of cigarettes smoked was associated with a higher prevalence of hospitalization (AOR: 1.30, 95% CI: 1.10–1.53) and ICU admission (AOR: 1.23, 95% CI: 1.04–1.44). Conclusions: Smoking status, pack-years, and intensity of smoking were associated with hospitalizations in patients with COVID-19 and intensity of smoking was associated with ICU admission. The findings underscore the need for detailed information beyond smoking status when evaluating smokers with COVID-19 so that the potential for adverse sequelae may be optimally managed in at-risk patients.
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spelling pubmed-84316792021-09-11 Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity Mahabee-Gittens, E. Melinda Mendy, Angelico Merianos, Ashley L. Int J Environ Res Public Health Article Objective: Smoking status does not indicate the amount or length of tobacco use, and thus, it is an imperfect measure to assess the association between cigarette smoking and severe coronavirus disease 2019 (COVID-19) outcomes. This investigation assessed whether cigarette smoking status, intensity of smoking (i.e., average daily packs of cigarettes smoked), duration of smoking, and pack-years of smoking are associated with severe outcomes among adults diagnosed with COVID-19. Methods: We conducted a retrospective, cross-sectional study in which we identified consecutive patients diagnosed with COVID-19 at the University of Cincinnati healthcare system between 13 March 2020 and 30 September 2020 who had complete information on smoking status, severe COVID-19 outcomes, and covariates (i.e., demographics and comorbidities). We used logistic regression to evaluate the associations of smoking status and intensity of smoking with COVID-19 severity, defined as hospitalization, admission to intensive care unit (ICU), or death, adjusting for sociodemographics and comorbidities. Results: Among the 4611 COVID-19 patients included in the analysis, 18.2% were current smokers and 20.7% were former smokers. The prevalence of COVID-19 outcomes was 28.9% for hospitalization, 9.8% for ICU admission, and 1.4% for death. In the adjusted analysis, current smoking (AOR: 1.23, 95% CI: 1.02–1.49), former smoking (AOR: 1.28, 95% CI: 1.07–1.54), and pack-years of smoking (AOR: 1.09, 95% CI: 1.02–1.17) were associated with a higher prevalence of hospitalization. Average daily packs of cigarettes smoked was associated with a higher prevalence of hospitalization (AOR: 1.30, 95% CI: 1.10–1.53) and ICU admission (AOR: 1.23, 95% CI: 1.04–1.44). Conclusions: Smoking status, pack-years, and intensity of smoking were associated with hospitalizations in patients with COVID-19 and intensity of smoking was associated with ICU admission. The findings underscore the need for detailed information beyond smoking status when evaluating smokers with COVID-19 so that the potential for adverse sequelae may be optimally managed in at-risk patients. MDPI 2021-08-25 /pmc/articles/PMC8431679/ /pubmed/34501529 http://dx.doi.org/10.3390/ijerph18178939 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mahabee-Gittens, E. Melinda
Mendy, Angelico
Merianos, Ashley L.
Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity
title Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity
title_full Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity
title_fullStr Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity
title_full_unstemmed Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity
title_short Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity
title_sort assessment of severe covid-19 outcomes using measures of smoking status and smoking intensity
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431679/
https://www.ncbi.nlm.nih.gov/pubmed/34501529
http://dx.doi.org/10.3390/ijerph18178939
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