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Smoking status related to Covid-19 mortality and disease severity in a veteran population.
Wilkinson, Laura A; Mergenhagen, Kari A; Carter, Michael T; Chua, Hubert; Clark, Collin; Wattengel, Bethany A; Sellick, John A; El-Solh, Ali A.
  • Wilkinson LA; Veteran Affairs Western New York Healthcare System, Department of Pharmacy, Buffalo, NY, United States.
  • Mergenhagen KA; Veteran Affairs Western New York Healthcare System, Department of Pharmacy, Buffalo, NY, United States. Electronic address: Kari.Mergenhagen@va.gov.
  • Carter MT; Veteran Affairs Western New York Healthcare System, Department of Pharmacy, Buffalo, NY, United States.
  • Chua H; Veteran Affairs Western New York Healthcare System, Department of Pharmacy, Buffalo, NY, United States.
  • Clark C; University at Buffalo School of Pharmacy and Pharmaceutical Sciences, United States.
  • Wattengel BA; Veteran Affairs Western New York Healthcare System, Department of Pharmacy, Buffalo, NY, United States.
  • Sellick JA; Veteran Affairs Western New York Healthcare System, Department of Infectious Diseases, Buffalo, NY, United States; Jacobs School of Medicine and Biomedical Sciences, Department of Internal Medicine, Buffalo, NY, United States.
  • El-Solh AA; Veteran Affairs Western New York Healthcare System, Department of Research and Development, Buffalo, NY, United States.
Respir Med ; 190: 106668, 2021 12.
Article in English | MEDLINE | ID: covidwho-1487956
ABSTRACT

INTRODUCTION:

Cigarette smoking is associated with development of significant comorbidities. Patients with underlying comorbidities have been found to have worse outcomes associated with Coronavirus Disease 2019 (Covid-19). This study evaluated 30-day mortality in Covid-19 positive patients based on smoking status.

METHODS:

This retrospective study of veterans nationwide examined Covid-19 positive inpatients between March 2020 and January 2021. Bivariate analysis compared patients based on smoking history. Propensity score matching adjusted for age, gender, race, ethnicity, Charlson comorbidity index (0-5 and 6-19) and dexamethasone use was performed. A multivariable logistic regression with backwards elimination and Cox Proportional Hazards Ratio was utilized to determine odds of 30-day mortality.

RESULTS:

The study cohort consisted of 25,958 unique Covid-19 positive inpatients. There was a total of 2,995 current smokers, 12,169 former smokers, and 8,392 non-smokers. Death was experienced by 13.5% (n = 3503) of the cohort within 30 days. Former smokers (OR 1.15; 95% CI, 1.05-1.27) (HR 1.13; 95% CI, 1.03-1.23) had higher risk of 30-day mortality compared with non-smokers. Former smokers had a higher risk of death compared to current smokers (HR 1.16 95% CI 1.02-1.33). The odds of death for current vs. non-smokers did not significantly differ.

CONCLUSION:

Compared to veteran non-smokers with Covid-19, former, but not current smokers with Covid-19 had a significantly higher risk of 30-day mortality.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Veterans / Smoking / Smokers / COVID-19 / Inpatients Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Respir Med Year: 2021 Document Type: Article Affiliation country: J.rmed.2021.106668

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Veterans / Smoking / Smokers / COVID-19 / Inpatients Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Respir Med Year: 2021 Document Type: Article Affiliation country: J.rmed.2021.106668