IMPACT OF SMOKING ON THE SEVERITY AND OUTCOMES OF CORONAVIRUS DISEASE: A RETROSPECTIVE ANALYSIS
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Keywords
COVID-19, smoking, disease severity, ICU admission, mortality, respiratory symptoms
Abstract
Background: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has led to global morbidity and mortality, with increasing recognition of risk factors that exacerbate disease severity. Smoking has been hypothesized to impact COVID-19 outcomes due to its known effects on the respiratory and immune systems, but evidence remains controversial.
Objective: This study aimed to investigate the association between smoking and the severity of COVID-19 outcomes. Specifically, we sought to compare the clinical characteristics, disease progression, and outcomes between smokers and non-smokers diagnosed with COVID-19.
Methodology: A retrospective analysis was conducted on 198 COVID-19 patients admitted to a private tertiary care hospital. Data were extracted from electronic medical records and included demographics, smoking status, comorbidities, clinical presentations, laboratory and radiological findings, disease severity, treatment modalities, and outcomes. Smokers were compared to non-smokers across various parameters. Statistical analyses were performed to determine significant differences between the two groups.
Results: Among the 198 patients, 38% were smokers. Smokers had a higher mean age (52 years vs. 49 years, p=0.042) and were more likely to have comorbidities such as hypertension, diabetes, and COPD. Clinically, smokers presented with more severe respiratory symptoms, higher inflammatory markers, and greater radiological lung involvement. Smokers were more likely to progress to severe COVID-19, requiring ICU admission (50.7% vs. 17.9%, p<0.001) and mechanical ventilation (46.7% vs. 13.8%, p<0.001), and had a higher mortality rate (40.0% vs. 14.6%, p<0.001).
Conclusion: Smoking significantly worsens COVID-19 outcomes, with smokers experiencing more severe disease progression, higher ICU admission rates, and increased mortality compared to non-smokers. The findings emphasize the need for targeted public health interventions to address smoking as a modifiable risk factor in COVID-19 management.
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Mahvesh Mahmud
Associate Professor Nephrology Watim Medical College, Rawalpindi
Muddasar Pervaiz
MBBS, MPH, Associate Professor in Community Medicine Department, Al-Nafees Medical College, Islamabad
Shafaq Altaf
MBBS FCPS (Internal Medicine), Senior Registrar Watim Medical College, Rawalpindi
Anas Khan Channa
MBBS FCPS (Internal Medicine), Senior Registrar Watim Medical College, Rawalpindi
Mishaal Hafeez
MBBS, House Officer, Federal General Hospital, Islamabad
Iqra Ibrar
MBBS,House Officer, Federal General Hospital, Islamabad