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Article

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

1
Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
2
Division of Epidemiology, Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
3
School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Zubair Kabir and Alberto Ruano-Ravina
Int. J. Environ. Res. Public Health 2021, 18(17), 8939; https://doi.org/10.3390/ijerph18178939
Received: 8 June 2021 / Revised: 16 August 2021 / Accepted: 19 August 2021 / Published: 25 August 2021
(This article belongs to the Special Issue Tobacco Smoke Exposure and Tobacco Product Use)
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. View Full-Text
Keywords: smoking; tobacco use; COVID-19; hospitalization; intensive care unit smoking; tobacco use; COVID-19; hospitalization; intensive care unit
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MDPI and ACS Style

Mahabee-Gittens, E.M.; Mendy, A.; Merianos, A.L. Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity. Int. J. Environ. Res. Public Health 2021, 18, 8939. https://doi.org/10.3390/ijerph18178939

AMA Style

Mahabee-Gittens EM, Mendy A, Merianos AL. Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity. International Journal of Environmental Research and Public Health. 2021; 18(17):8939. https://doi.org/10.3390/ijerph18178939

Chicago/Turabian Style

Mahabee-Gittens, E. Melinda, Angelico Mendy, and Ashley L. Merianos. 2021. "Assessment of Severe COVID-19 Outcomes Using Measures of Smoking Status and Smoking Intensity" International Journal of Environmental Research and Public Health 18, no. 17: 8939. https://doi.org/10.3390/ijerph18178939

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