Impact of Tobacco Smoking on the Risk of COVID-19. A Large Scale Retrospective Cohort Study.
Tuesday, January 19, 2021
Posted by: Natalia Gromov
Paleiron
N, Mayet A, Marbac V, Perisse A, Barazzutti H, Brocq FX, Janvier F, Bertrand D,
Bylicki O.
Impact of Tobacco Smoking
on the Risk of COVID-19. A Large Scale Retrospective Cohort Study.
Nicotine Tob Res. 2021 Jan 9:ntab004. doi: 10.1093/ntr/ntab004. Epub ahead of
print. PMID: 33420786.
Introduction.
Preliminary reports indicated that smokers could be less susceptible to the
coronavirus SARS-CoV-2, which causes Covid-19. However, once infected an
increased risk of severe disease is reported. We investigated the association
between smoking and COVID-19 during an outbreak of the disease on a naval
vessel.
Methods.
We conducted a cross-sectional, observational study on the 1769 sailors of a
same navy aircraft carrier at sea exposed at the same time to SARS-CoV2 to
investigate the link between tobacco consumption and Covid-19.
Results.
Among the 1688 crewmembers (87% men; median age= 28 (IQR 23-35)) included, 1279
(76%) developed Covid-19 (1038 (62%) RT-PCR-positive and 241 (14%) with only
clinical signs). One hundred and seven patients were hospitalized. The
univariable analysis odds ratio (OR) for Covid-19 infection was 0.59 (95%
confidence interval (CI), 0.45-0.78; P<0.001) for current smokers vs. former
and nonsmokers; sex, body mass index or blood group had no significant impact.
Crewmembers >50 years old had an increased risk of contracting Covid-19 (OR,
2.84 [95% CI, 1.30-7.5]; P=0.01). Multivariable analysis retained the lower
risk of current smokers becoming infected (OR, 0.64 [0.49-0.84]; P<0.001)
and age >50 years was significatively associated with Covid-19 (OR, 2.6
[1.17-6.9]; P=0.03).
Conclusions.
Current smoking status was associated with a lower risk of developing Covid-19
but cannot be considered as an efficient protection against infection.
Mechanism of the lower susceptibility of smokers to SARS-CoV-2 requires further
research.
Implications.
Recent epidemiologic data suggest a paradoxical link between smoking and
Covid-19. Among the 1688 crewmembers (with an attack rate of 76% and exposed at
the same time in the same place to SARS-CoV2), we found a significant lower
risk for developing COVID-19 in current smokers (71%) versus former and non
smokers (80%). This finding strongly supports the need for further research on
nicotine physiological pathway and its impact on COVID-19 infection whilst
emphasizing that tobacco smoking should not be considered as an efficient
protection against COVID-19.
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