{"id":96,"date":"2020-04-08T08:01:09","date_gmt":"2020-04-08T08:01:09","guid":{"rendered":"https:\/\/blogs.bmj.com\/covid-19\/?p=96"},"modified":"2020-04-08T08:01:09","modified_gmt":"2020-04-08T08:01:09","slug":"smoking-history-is-an-important-risk-factor-for-severe-covid-19","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/covid-19\/2020\/04\/08\/smoking-history-is-an-important-risk-factor-for-severe-covid-19\/","title":{"rendered":"Smoking history is an important risk factor for severe COVID-19"},"content":{"rendered":"

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Giuseppe Gorini, Luke Clancy, Esteve Fernandez and Silvano Gallus<\/strong><\/p>\n

Current evidence suggests that an association exists between smoking and COVID-19 severity, in line with recent research which has shown that smoking is associated with increased risk of acute respiratory distress syndrome. Moreover, a study based on 1099 COVID-19 patients<\/a> showed that 31.7% of patients with a smoking history had severe COVID-19 disease at the time of hospital admission, compared to 14.5% among never-smokers; crude odds ratio (OR): 1.87 (95% CI: 1.21-2.86). Likewise, 16.2% of patients with smoking history recorded a primary end-point event (i.e., admission to the intensive care unit, use of mechanical ventilation or death), compared to 4.7% among never-smokers; OR: 3.25 (95% CI: 1.79-5.73).<\/p>\n

These data are in line with a study based on 78 patients with COVID-19 pneumonia<\/a> which showed 27.3% of ever-smokers did not improve after 2 weeks, compared to 3.0% among never-smokers. In multivariate analysis, smoking history recorded the highest OR (14.29; 95% CI: 1.58-25.00).<\/p>\n

In conclusion, although smoking might not be related to COVID-19 incidence<\/a>, in the absence of more data, tobacco smoking appears to be the most important avoidable risk factor for a poorer prognosis in COVID-19. Smoking status should be recorded in all surveillance systems for COVID-19 in every country. We concur with the recommendation to quit smoking<\/a> to avoid complications in case of COVID-19 infection. In line with this, now is the time to make Smoking Cessation Services available free of charge in every country capable of delivering such a service.<\/p>\n