IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i17p8939-d621497.html
   My bibliography  Save this article

Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity

Author

Listed:
  • E. Melinda Mahabee-Gittens

    (Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA)

  • Angelico Mendy

    (Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA)

  • Ashley L. Merianos

    (School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA)

Abstract

Objective: Smoking status does not indicate the amount or length of tobacco use, and thus, it is an imperfect measure to assess the association between cigarette smoking and severe coronavirus disease 2019 (COVID-19) outcomes. This investigation assessed whether cigarette smoking status, intensity of smoking (i.e., average daily packs of cigarettes smoked), duration of smoking, and pack-years of smoking are associated with severe outcomes among adults diagnosed with COVID-19. Methods: We conducted a retrospective, cross-sectional study in which we identified consecutive patients diagnosed with COVID-19 at the University of Cincinnati healthcare system between 13 March 2020 and 30 September 2020 who had complete information on smoking status, severe COVID-19 outcomes, and covariates (i.e., demographics and comorbidities). We used logistic regression to evaluate the associations of smoking status and intensity of smoking with COVID-19 severity, defined as hospitalization, admission to intensive care unit (ICU), or death, adjusting for sociodemographics and comorbidities. Results: Among the 4611 COVID-19 patients included in the analysis, 18.2% were current smokers and 20.7% were former smokers. The prevalence of COVID-19 outcomes was 28.9% for hospitalization, 9.8% for ICU admission, and 1.4% for death. In the adjusted analysis, current smoking (AOR: 1.23, 95% CI: 1.02–1.49), former smoking (AOR: 1.28, 95% CI: 1.07–1.54), and pack-years of smoking (AOR: 1.09, 95% CI: 1.02–1.17) were associated with a higher prevalence of hospitalization. Average daily packs of cigarettes smoked was associated with a higher prevalence of hospitalization (AOR: 1.30, 95% CI: 1.10–1.53) and ICU admission (AOR: 1.23, 95% CI: 1.04–1.44). Conclusions: Smoking status, pack-years, and intensity of smoking were associated with hospitalizations in patients with COVID-19 and intensity of smoking was associated with ICU admission. The findings underscore the need for detailed information beyond smoking status when evaluating smokers with COVID-19 so that the potential for adverse sequelae may be optimally managed in at-risk patients.

Suggested Citation

  • E. Melinda Mahabee-Gittens & Angelico Mendy & Ashley L. Merianos, 2021. "Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity," IJERPH, MDPI, vol. 18(17), pages 1-9, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:17:p:8939-:d:621497
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/17/8939/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/17/8939/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Nicky Phillips, 2021. "The coronavirus is here to stay — here’s what that means," Nature, Nature, vol. 590(7846), pages 382-384, February.
    2. Agnieszka Strzelak & Aleksandra Ratajczak & Aleksander Adamiec & Wojciech Feleszko, 2018. "Tobacco Smoke Induces and Alters Immune Responses in the Lung Triggering Inflammation, Allergy, Asthma and Other Lung Diseases: A Mechanistic Review," IJERPH, MDPI, vol. 15(5), pages 1-35, May.
    3. Vadsala Baskaran & Rachael L Murray & Abby Hunter & Wei Shen Lim & Tricia M McKeever, 2019. "Effect of tobacco smoking on the risk of developing community acquired pneumonia: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-18, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Carol Nash, 2022. "Enhancing Hopeful Resilience Regarding Depression and Anxiety with a Narrative Method of Ordering Memory Effective in Researchers Experiencing Burnout," Challenges, MDPI, vol. 13(2), pages 1-15, June.
    2. Bradley, Jake & Ruggieri, Alessandro & Spencer, Adam Hal, 2021. "Twin Peaks: Covid-19 and the labor market," European Economic Review, Elsevier, vol. 138(C).
    3. Martin Hellwig & Viola Priesemann & Guntram B. Wolff, 2021. "Reducing the Mobility of SARS-CoV-2 Variants to Safeguard Containments," Intereconomics: Review of European Economic Policy, Springer;ZBW - Leibniz Information Centre for Economics;Centre for European Policy Studies (CEPS), vol. 56(4), pages 234-236, July.
    4. Iris Gavish & Yossi Gavish, 2021. "Using COVID-19 Symbols in Anti-Smoking Fear Appeal Advertisements for Encouraging Smoking Cessation among Israeli Smokers," IJERPH, MDPI, vol. 18(20), pages 1-12, October.
    5. Markus Braun & Doris Klingelhöfer & Gerhard M. Oremek & David Quarcoo & David A. Groneberg, 2020. "Influence of Second-Hand Smoke and Prenatal Tobacco Smoke Exposure on Biomarkers, Genetics and Physiological Processes in Children—An Overview in Research Insights of the Last Few Years," IJERPH, MDPI, vol. 17(9), pages 1-25, May.
    6. Ivan Berlin, 2022. "Potential Bias in Assessing the Tobacco/Nicotine—COVID-19 Association—How to Improve Our Level of Understanding," IJERPH, MDPI, vol. 19(21), pages 1-6, October.
    7. Holger Strulik & Volker Grossmann, 2022. "Life Cycle Economics with Infectious and Chronic Diseases," CESifo Working Paper Series 10141, CESifo.
    8. Weichen Wang & Andrea Gurgone & Humberto Martínez & Maria Cristina Barbieri Góes & Ettore Gallo & Ádam Kerényi & Enrico Maria Turco & Carla Coburger & Pêdra D. S. Andrade, 2022. "COVID-19 Mortality and Economic Losses: The Role of Policies and Structural Conditions," JRFM, MDPI, vol. 15(8), pages 1-28, August.
    9. Anna Maria Stabile & Alessandra Pistilli & Desirée Bartolini & Eleonora Angelucci & Marco Dell’Omo & Gabriele Di Sante & Mario Rende, 2022. "Short-Term Effects of Side-Stream Smoke on Nerve Growth Factor and Its Receptors TrKA and p75 NTR in a Group of Non-Smokers," IJERPH, MDPI, vol. 19(16), pages 1-11, August.
    10. E. Melinda Mahabee-Gittens & Ashley L. Merianos & Patricia C. Fulkerson & Lara Stone & Georg E. Matt, 2019. "The Association of Environmental Tobacco Smoke Exposure and Inflammatory Markers in Hospitalized Children," IJERPH, MDPI, vol. 16(23), pages 1-10, November.
    11. Maureen Rebecca Smith & Maria Trofimova & Ariane Weber & Yannick Duport & Denise Kühnert & Max von Kleist, 2021. "Rapid incidence estimation from SARS-CoV-2 genomes reveals decreased case detection in Europe during summer 2020," Nature Communications, Nature, vol. 12(1), pages 1-13, December.
    12. Mohamed Fareh & Wei Zhao & Wenxin Hu & Joshua M. L. Casan & Amit Kumar & Jori Symons & Jennifer M. Zerbato & Danielle Fong & Ilia Voskoboinik & Paul G. Ekert & Rajeev Rudraraju & Damian F. J. Purcell , 2021. "Reprogrammed CRISPR-Cas13b suppresses SARS-CoV-2 replication and circumvents its mutational escape through mismatch tolerance," Nature Communications, Nature, vol. 12(1), pages 1-16, December.
    13. Giulia Squillacioti & Valeria Bellisario & Elena Grignani & Giulio Mengozzi & Giulia Bardaglio & Paola Dalmasso & Roberto Bono, 2019. "The Asti Study: The Induction of Oxidative Stress in A Population of Children According to Their Body Composition and Passive Tobacco Smoking Exposure," IJERPH, MDPI, vol. 16(3), pages 1-11, February.
    14. Emmanuel Peprah & Mari Armstrong-Hough & Stephanie H. Cook & Barbara Mukasa & Jacquelyn Y. Taylor & Huichun Xu & Linda Chang & Joyce Gyamfi & Nessa Ryan & Temitope Ojo & Anya Snyder & Juliet Iwelunmor, 2021. "An Emerging Syndemic of Smoking and Cardiopulmonary Diseases in People Living with HIV in Africa," IJERPH, MDPI, vol. 18(6), pages 1-12, March.
    15. Patrick Mellacher, 2022. "Endogenous viral mutations, evolutionary selection, and containment policy design," Journal of Economic Interaction and Coordination, Springer;Society for Economic Science with Heterogeneous Interacting Agents, vol. 17(3), pages 801-825, July.
    16. Carlo Corradini & Jesse Matheson & Enrico Vanino, 2024. "Neighbourhood labour structure, lockdown policies, and the uneven spread of COVID‐19: within‐city evidence from England," Economica, London School of Economics and Political Science, vol. 91(363), pages 944-979, July.
    17. Schroeder, Max & Lazarakis, Spyridon & Mancy, Rebecca & Angelopoulos, Konstantinos, 2023. "An extended period of elevated influenza mortality risk follows the main waves of influenza pandemics," Social Science & Medicine, Elsevier, vol. 328(C).
    18. Pengxiang Zhai & Fei Wu & Qiang Ji & Duc Khuong Nguyen, 2024. "From fears to recession? Time‐frequency risk contagion among stock and credit default swap markets during the COVID pandemic," International Journal of Finance & Economics, John Wiley & Sons, Ltd., vol. 29(1), pages 551-580, January.
    19. Kelsey M. Haas & Michael J. McGregor & Mehdi Bouhaddou & Benjamin J. Polacco & Eun-Young Kim & Thong T. Nguyen & Billy W. Newton & Matthew Urbanowski & Heejin Kim & Michael A. P. Williams & Veronica V, 2023. "Proteomic and genetic analyses of influenza A viruses identify pan-viral host targets," Nature Communications, Nature, vol. 14(1), pages 1-27, December.
    20. Teixeira, João Filipe & Silva, Cecília & Moura e Sá, Frederico, 2022. "The strengths and weaknesses of bike sharing as an alternative mode during disruptive public health crisis: A qualitative analysis on the users’ motivations during COVID-19," Transport Policy, Elsevier, vol. 129(C), pages 24-37.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:17:p:8939-:d:621497. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.