ABSTRACT
Aim: To investigate the association between tobacco smoking habits and severity and mortality of COVID-19 disease among ICU hospitalized patients. Material: Baseline sociodemographic, co-morbidities and clinical characteristics of 222 adult (70 women) COVID-19 hospitalized patients, aged 69+/-8yrs, mean ICU length of stay 35+/-12 days, were retrospectively collected and analyzed from 01/08/2020-01/08/2021. Also, information about caregivers' tobacco smoking behaviors were obtained. Result(s): 57 patients were current smokers (35+/-4 pack/yrs) and 61 ex-smokers(28+/-9pack/yrs). E-cigarette users were 18 patients (2 ex-smokers), dual users 22 (all current smokers). 37 continued to smoke up to hospital admission. Arterial hypertension (47/35) diabetes (44/24), betamuI>30 (22/34), coronary disease (40/22) and COPD (41/28) noted as main comorbidities in current smokers and ex-smokers. CT findings of pulmonary emphysema were detected in 31% of current and ex-smokers. 51% (113) of total patients died, aged 71+/-4 yrs, and ICU length of stay 40+/-15 days. Current smokers and ex-smokers were hospitalized in ICU for a longer period 29+/-7 days (p=0.001). APACHE II (48+/-8) and SOFA score (11+/-3) were higher in current smokers and ex-smokers (p=0.003). 53% of ICU patients had a family member that smoked, and 35% of them were willing to undergo a Tobacco Prevention and Cessation Program. 90% of current smokers after ICU discharge quitted smoking. Conclusion(s): Tobacco smoking is a serious comorbidity in ICU patients hospitalized for covid 19 disease, with both current smokers and ex-smokers reveal more severe rates of mortality and morbidity.
ABSTRACT
Aim: Gastrointestinal (GI) symptoms have been reported with coronavirus disease (COVID-19), but our understanding of their clinical significance is limited and this can be a safety concern for surgeons as patients might present with GI symptoms only. Method(s): A prospectively maintained database of emergency patients was reviewed between 20/03/2020 and 20/04/2020 (Cohort A) and 05/01/2021-26/ 01/2021. (Cohort B) All of them had a positive Polymerase Chain Reaction (PCR) COVID-19 test. We evaluated the prevalence of GI symptoms and their association with the severity of COVID-19 and looked at the prevalence of symptoms in different ethnicities. Chi-squared test in R software environment was used to analyse the data. Result(s): Cohort A consisted of 189 patients (100 male) 14 had nausea, 18 vomiting, 39 diarrhoea and 9 abdominal pain. 17 had ITU admissions and 68 died. Cohort B consisted of 348 patients (185 male) 50 had nausea, 46 vomiting, diarrhoea 84 and 23 had abdominal pain. 30 had ITU admissions and 75 died. In this cohort the COVID-19 Alpha Variant was making up nearly 100% of cases. Nausea was more common in Cohort B 50/348 (P = 0.01641) There was no difference in vomiting (18/189 Cohort A P = 0.198898), diarrhoea (39/189 Cohort A, P = 0.3385) and abdominal pain (9/189 Cohort A P = 0.379). There was no difference in GI symptoms for the severe and non-severe cases in Cohort A (P = 0.150813) but they were more prevalent in the non-severe group of Cohort B (P = 0.008). There was no diifference between ethnic groups in terms of GI symptoms (Cohort A 35 Black patients,17 Asian, 102 White and 35 Other Ethnicities, Cohort B 40 Black, 33 Asian, 174 White and 101 Other Ethnicities). Conclusion(s): Acute GI symptoms associated with COVID-19 are highly prevalent and were seen more often in non-severe cases of Cohort B. The SARS-CoV- 2 Alpha Variant was endemic in our region and the UK vaccination programme was being rolled out at the time of our study. More research is required to establish the significance of these factors.