Abstract
INTRODUCTIONThere has been significant speculation regarding the association between the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pathogen, coronavirus disease (COVID-19) and smoking. We provide an overview of the available literature regarding the association between smoking, risk of SARS-CoV-2 infection, and risk of severe COVID-19 and poor clinical outcomes, with the aim of informing public health policy and practice, particularly in England.METHODSPublications were identified utilising a systematic search approach on PUBMED and Google Scholar. Publications presenting a systematic review or meta-analysis considering the association between smoking and SARS-COV-2 infection or COVID-19 outcomes were included.RESULTSEight studies were identified. One considered the relationship between smoking and the probability of SARS-CoV-2 infection, three considered the association between COVID-19 hospitalisation and smoking history, and six reviewed the association between smoking history and development of severe COVID-19. One study specifically investigated the risk of mortality. The studies considering risk of severe disease indicate that there is a significant association between COVID-19 and current or ever smoking.CONCLUSIONSThis is a rapidly evolving topic. Current analysis remains limited due to the quality of primary data, although, early results indicate an association between smoking and COVID-19 severity. We highly recommend public health messaging to continue focusing on smoking cessation efforts.
Highlights
There has been significant speculation regarding the association between the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pathogen, coronavirus disease (COVID-19) and smoking
A search for existing systematic reviews and metaanalyses published between 1 January and 8 May 2020 was undertaken on PubMed, utilising the search terms: ‘Smoking’, ‘Nicotine’, ‘COVID-19’, ‘SARSCoV-2’, and ‘Coronavirus’, in pairwise combinations
The results showed that current smokers were at reduced risk of testing positive for COVID-19 compared to never smokers
Summary
There has been significant speculation regarding the association between the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pathogen, coronavirus disease (COVID-19) and smoking. The current coronavirus disease (COVID-19) pandemic presents a significant public health threat, posing an immediate risk to the health of the global population, and creating far-reaching, long-term consequences. As this new virus spreads, questions continue to emerge regarding risk factors. One widely debated question is the potential effect of smoking on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates and on the clinical outcomes of the resulting disease, COVID-19. Smokers are not currently identified as a vulnerable group within the UK Government’s COVID-19 guidance on social distancing
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