Evaluating the Effect of Smoking on COVID-19 Severity in Patients Admitted to Shahid Mohammadi Hospital in Bandar Abbas During 2021-2022

Abstract

Background: The coronavirus disease 2019 (COVID-19) is a newborn virus that has become an emergency since December 2019. A severe form of this disease is accompanied by intensive care unit (ICU) admission and death. The COVID-19 pandemic is still occurring in several countries; however, few facts are available about the disease. Risk factors and protective factors of this disease are still unknown. We know that smoking is a risk factor for several respiratory infections. However, considering some previous studies and nicotine’s anti-inflammatory mechanism, a smoking paradox in COVID-19 still persists as an obscure issue. Thus, we decided to evaluate the association between smoking and COVID-19 disease. Materials and Methods: In this study, sampling was performed simply and randomly from all admitted COVID-19 patients in 2020-2021. This is a retrograde case-control study, and 92 COVID-19 patients with a history of smoking were enrolled in the case group, and 92 COVID-19 patients without any smoking history were selected for the control group. Data were collected through a checklist. In this checklist, information such as the patient’s age, gender, and medical condition was recorded. In the end, collected data were analyzed by SPSS software version 26.0. Results: In this study, we used a logistic regression test to indicate that smoking had a significant relationship with subsequent plasmapheresis (P=0.001). We also found a significant relationship between cigarette smoking and plasmapheresis (P<0.001). Furthermore, old age and diabetes were related to ICU admission (P=0.001 and P<0.000, respectively), and male gender and hypertension were related to plasmapheresis (P=0.007 and P=0.001, respectively). Moreover, only old age was related to mortality caused by COVID-19 infection (P=0.025). Conclusion: Considering the issue of the smoking paradox in COVID-19, the association between smoking and COVID-19 disease was evaluated in this study. it was found that smoking is related to the need for plasmapheresis and was not related to ICU admission or death. Cigarette smoking had the same association. It should be noted that plasmapheresis had no significant relation with ICU admission and death. Moreover, hookah smoking had no relationship with plasmapheresis, ICU admission, and death. This study also evaluated other factors such as age, gender, and medical conditions such as hypertension, diabetes, and cardiovascular disease and their effect on COVID-19. We found that only old age was related to mortality caused by COVID-19.