The association of smoking status with SARS-CoV-2 infection, hospitalisation and mortality from COVID-19: A living rapid evidence review (version 4)

ABSTRACT

Background: SARS-CoV-2 is the causative agent of COVID-19, an emergent zoonotic disease which has reached pandemic levels and is designated a public health emergency of international concern. It is plausible that former or current smoking status is associated with infection, hospitalisation and/or mortality from COVID-19. Objective: We aimed to estimate the association of smoking status with rates of i) infection, ii) hospitalisation, iii) disease severity, and iv) mortality from SARS-CoV-2/COVID-19 disease. Methods: This is a living evidence review with frequent updates. We adopted recommended practice for rapid evidence reviews, which involved limiting the search to main databases and having one reviewer extract data and another verify. Published articles and pre-prints were identified via Ovid MEDLINE, medRxiv and expertise within the review team. We included observational or experimental studies with community-dwelling or hospitalised adults aged 16 years who had received a test for SARS-CoV-2 infection or a diagnosis of COVID-19, providing that data on smoking status were reported. Studies were judged as ‘good' quality if they i) had low levels of missing data on smoking status (i.e.