Background: Cigarette smoking has been proven to be a risk factor in the development of many diseases . However, it remains controversial with respect to the relationship of smoking with COVID-19 . The purpose of this study was to explore the role of smoking in COVID-19 .
Methods: A total of 622 patients with COVID-19 in China were enrolled in the study . Corresponding clinical and laboratory data were collected and analyzed . Meanwhile, Kaplan-Meier curve and Cox regression analysis were employed to analyze the association of smoking with survival in patients with COVID-19 .
Results: Smoking was statistically significant comparing non-survivors and survivors of patients with COVID-19 (P = 0.007). Males had higher proportion of smoking than females (91.9% vs. 8.1%, P <0.001). Compared with the non-smoker, there was significant statistical difference in the incidence of cerebrovascular disease in smoking patients with COVID-19 (9.7% vs. 3.4%, P = 0.017). White blood cell count (6.3 vs. 5.4; P = 0.037), hemoglobin level (139.0 vs. 127.0; P <0.001), and creatinine level (77.3 vs. 61.0; P <0.001) were significantly increased in COVID-19 patients who smoked . Moreover, smoking patients showed a worse survival compared with non-smoking patients (Log Rank P = 0.045). After adjustment for age, gender and underlying diseases, patients with smoking still had higher risk of mortality than that of non-smoking patients (hazard ratio [HR] 1.897 , 95% confidence interval [CI] 1.058-3.402, P = 0.032). Conclusion: Smoking was thought to be a risk factor in predicting the prognosis of COVID-19 and smoking patients might have a higher risk of mortality than that of the non-smoking patients.
Index: ACE2, COVID-19, SARS-CoV-2, cigarette, inflammation, prognosis, smoking