Smoking and Severity of COVID-19 Infection: A Short Systematic Review and Meta-analysis

Author(s): Samirah Abdulrahman Alghamdi, Abdulrahman Saeed Alahmari, Souad Khalid Bajari, Thamer Mussad Alzahrani, Nuha Hassan Alsubhi, Ahmed Abdulrahman Alolah, Abdulaziz Marzouq Alotaibi, Ali Abdulghalib Alhayek, Ghazi Talal Almohmmadi and Ibrahim Tariq Almohawis

Background: There has been sizeable speculation regarding the association between the severe Acute breathing Syndrome Coronavirus 2 (SARS-CoV-2) pathogen, coronavirus disorder (COVID-19), and smoking. Aim: This work aims to determine the link between smoking and COVID-19 infection. Materials and Methods: A systematic search was performed over different medical databases to identify Internal Medicine studies, which studied the outcome of the Smokers group versus the Non-Smokers group of COVID-19 patients. Using the meta-analysis process, either with fixed or random-effects models, we conducted a meta-analysis on the prevalence of severe cases as a primary outcome, and on mortality rate as a secondary outcome. Results: Eleven studies were identified involving 146793 patients, 11973 in the Smokers group, and 134820 in the Non-Smokers group. The meta-analysis process revealed that the pooled prevalence of severity among COVID-19 patients was (27.7%), and there is a significant increase in COVID-19 severe cases in the Smokers group compared to the Non-Smokers group (OR=2.11, P=0.032). The pooled mortality rate among COVID-19 patients was (17.2%), and there is a significant increase in mortality in the Smokers group compared to the Non-Smokers group (OR=1.76, P=0.026). Conclusion: To conclude, Patients with any smoking history are vulnerable to severe COVID-19 and worse in-hospital outcomes. In the absence of current targeted therapies, preventative and supportive strategies to reduce morbidity and mortality in current and former smokers are crucial.


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