Smoking and COVID-19 in ICU Patients

BACKGROUND: Case studies revealed an astonishingly low number of current among patients suffering from symptomatic COVID-19 compared to general population, leading to the conclusion that smoking/nicotine uptake might have a preventive effect. OBJECTIVE: This study aims to show the relation between smoking habits, present and past, and severity and outcome in COVID-19 patients hospitalized in the ICU of the University Hospital in Pristina. METHODS: This paper reports the results of possible association between smoking habits and severity and outcome of COVID-19. Data on smoking habits, present and past, among 73 patients with severe COVID-19 hospitalized at ICU are analysed and presented. RESULTS: Smokers (active and ex-smokers) in total were 16 (21.9%) cases (P<0.0001); active smokers were 5 (6.8%) cases (P<0.0001), ex-smokers 11 (15.1%) cases (P<0.0001), and non-smokers were 57 (78.1%) of the cases. From 16 cases (21.92%) identified as active smoker and ex-smoker, 8 of them ended with death, and other 8 cases survived; while 40 cases (54.79%) from the non-smoker group died, while 17 cases (23.29%) from this group survived (95% CI: 0.2881 to 1.5430, P=0.3792). Out of 5 (6.85%) cases of active smokers, 3 (4.11%) of them ended with death (95% CI: 0.1692 to 2.6846, P=0.855); while from 11 (15.07%) of ex-smokers, 5 (6.85%) died (95% CI: 0.1995 to 1.6412, P=0.3561). OR for death among smoker group of cases (active and ex-smokers) was 0.4250 (95% CI: 0.1370 to 1.3189, P=0.1386); for active smokers 0.2550 (95% CI: 0.0547 to 1.1892, p=0.0820), and 0.3542 (95% CI: 0.0950 to 1.3199, P=0.1220) for ex-smokers. Data on the influence of smoking on incidence and severity of COVID-19 ICU cases are conflicting. CONCLUSION: A protective effect of smoking in COVID-19 should not be inferred.