Home > The role of smoking in COVID-19 progression: a comprehensive meta-analysis.

Gallus, Silvano and Scala, Marco and Possenti, Irene and Jarach, Carlotta Micaela and Clancy, Luke and Fernandez, Esteve and Gorini, Giuseppe and Carreras, Giulia and Malevolti, Maria Chiara and Commar, Alison and Fayokun, Ranti and Gouda, Hebe N and Prasad, Vinayak M and Lugo, Alessandra (2023) The role of smoking in COVID-19 progression: a comprehensive meta-analysis. European Respiratory Review, 32, (167), https://doi.org/10.1183/16000617.0191-2022.

External website: https://err.ersjournals.com/content/32/167/220191

The association between current smoking and coronavirus disease 2019 (COVID-19) progression remains uncertain. We aim to provide up-to-date evidence of the role of cigarette smoking in COVID-19 hospitalisation, severity and mortality. On 23 February 2022 we conducted an umbrella review and a traditional systematic review PubMed/Medline and Web of Science. We used random-effects meta-analyses to derive pooled odds ratios of COVID-19 outcomes for smokers in cohorts of severe acute respiratory syndrome coronavirus 2 infected individuals or COVID-19 patients. We followed the Meta-analysis of Observational Studies in Epidemiology reporting guidelines. PROSPERO: CRD42020207003. 320 publications were included. The pooled odds ratio for current never or nonsmokers was 1.08 (95% CI 0.98-1.19; 37 studies) for hospitalisation, 1.34 (95% CI 1.22-1.48; 124 studies) for severity and 1.32 (95% CI 1.20-1.45; 119 studies) for mortality. Estimates for former never-smokers were 1.16 (95% CI 1.03-1.31; 22 studies), 1.41 (95% CI: 1.25-1.59; 44 studies) and 1.46 (95% CI 1.31-1.62; 44 studies), respectively. Estimates for ever- never-smokers were 1.16 (95% CI 1.05-1.27; 33 studies), 1.44 (95% CI 1.31-1.58; 110 studies) and 1.39 (95% CI 1.29-1.50; 109 studies), respectively. We found a 30-50% excess risk of COVID-19 progression for current and former smokers compared with never-smokers. Preventing serious COVID-19 outcomes, including death, seems the newest compelling argument against smoking.

Item Type
Publication Type
Irish-related, International, Open Access, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Prevention, Harm reduction
31 March 2023
Identification #
ERS Publications

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