Smoking increases the risk of COVID-19 positivity, while Never-smoking reduces the risk

  1. Samson Barasa
  2. Josephine Kiage-Mokaya
  3. Katya Cruz-Madrid
  4. Michael Friedlander

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Abstract

Does smoking decrease the risk of testing positive for COVID-19 because the never-smokers (84%) prevalence is high and the current-smokers prevalence is low among COVID-19 positive patients? 1,2,3,4,5,6 We sought to determine whether never smoking increases the risk of COVID-19 positivity among the 50 to 69-year old patients because they are more likely to test positive for COVID-19. 7

Method

We conducted a retrospective chart review of COVID-19 Polymerase chain reaction, in-hospital tested ≥18-year-old patients. A Poisson regression analysis stratified into never-smokers and history of smoking (current + former smokers) was conducted.

Results

277 COVID-19 negative and 117 COVID-19 positive patients’ charts with a never-smokers prevalence of 42.32% and 54% respectively were analyzed. The never-smokers prevalence was 54%, 20-39-years; 61 %, 40 -49-years; 41%, 50 – 69-years; and 43%, 70 – 100-years.

The 40-49-year-old current and former smokers were more likely to test positive for COVID-19 [1.309 (1.047 - 1.635)], unlike the 40-49-year-old never-smokers [0.976 (0.890-1.071)] who had a lower risk.

Regardless of their smoking status, males [1.084(1.021 - 1.151)] and the 50-69-year-old patients [1.082 (1.014 -1.154)] were more likely to test positive for COVID-19, while end stage renal disease [0.908(0.843-0.978)] and non-COVID-19 respiratory viral illness [0.907 (0.863 - 0.953)] patients had a lower risk of COVID-19 positivity.

Heart failure [0.907 (0.830 - 0.991)], chronic obstructive pulmonary disease (COPD) [0.842 (0.745 - 0.952)] and Parkinson’s disease [0.823 (0.708 - 0.957)] never-smokers were less likely to test positive for COVID-19.

Conclusion

This is the first study to show that smoking increases the risk of COVID-19 positivity among the 40-49-year-old patients, while not smoking reduces the risk of COVID-19 positivity among the heart failure, COPD and Parkinson’s disease patients. This study emphasizes that COVID-19 positivity risk is not reduced by smoking and not increased by not smoking.

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  1. ScreenIT

    SciScore for 10.1101/2020.11.30.20241380: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The PeaceHealth institutional review board (IRB) approved the study and waived the written informed consent requirement.
    Consent: The PeaceHealth institutional review board (IRB) approved the study and waived the written informed consent requirement.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data collection: The Microsoft Access software was used to manage data after being extracted from the electronic medical records.
    Microsoft Access
    suggested: None
    The statistical analysis was performed using STATA version 15.
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: Limitations of our study included missing data and not all patients had laboratory tests done. Even though we didn’t have data on how long the former smokers had quit smoking, the analysis of never smokers versus current smokers (excluding former smokers) shown in supplementary S2 yielded similar results.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.11.30.20241380v1 on medRxiv