Lower Rate of Daily Smokers With Symptomatic COVID-19: A Monocentric Self-Report of Smoking Habit Study

  1. Makoto Miyara
  2. Florence Tubach
  3. Valérie Pourcher
  4. Capucine Morélot-Panzini
  5. Julie Pernet
  6. Julien Haroche
  7. Said Lebbah
  8. Elise Morawiec
  9. Guy Gorochov
  10. Eric Caumes
  11. Pierre Hausfater
  12. Alain Combes
  13. Thomas Similowski
  14. Zahir Amoura

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Background: Identification of prognostic factors in COVID-19 remains a global challenge. The role of smoking is still controversial.

Methods: PCR-positive in- and outpatients with symptomatic COVID-19 from a large French University hospital were systematically interviewed for their smoking status, use of e-cigarette, and nicotinic substitutes. The rates of daily smokers in in- and outpatients were compared using the same smoking habit questionnaire to those in the 2019 French general population, after standardisation for sex and age.

Results: The inpatient group was composed of 340 patients, median age of 66 years: 203 men (59.7%) and 137 women (40.3%), median age of both 66 years, with a rate of 4.1% daily smokers (CI 95% [2.3–6.9]) (5.4% of men and 2.2% of women). The outpatient group was composed of 139 patients, median age of 44 years: 62 men (44.6%, median age of 43 years) and 77 women (55.4%, median age of 44 years). The daily smoker rate was 6.1% (CI 95% [2.7–11.6], 5.1% of men and 6.8% of women). Amongst inpatients, daily smokers represented 2.2 and 3.4% of the 45 dead patients and of the 29 patients transferred to ICU, respectively. The rate of daily smokers was significantly lower in patients with symptomatic COVID-19, as compared to that in the French general population after standardisation by age and sex, with standardised incidence ratios (SIRs) of 0.24 [0.12–0.48] for outpatients and 0.24 [0.14–0.40] for inpatients.

Conclusions: Daily smoker rate in patients with symptomatic COVID-19 is lower as compared to the French general population

Article activity feed

  1. Version published to 10.3389/fmed.2021.668995
  2. ScreenIT

    SciScore for 10.1101/2020.06.10.20127514: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study has been approved by the ethics committee of Sorbonne University (2020 -
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    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:
    The rate of missing data - one of the more frequent caveat of studies reported so far - was very low (1.9%). Additionally, to completely rule out the impact of missing data on the conclusion of our study, we did a sensitivity analysis, considering that patients with missing smoking status as daily smokers, which is conservative regarding the hypothesis of a protective effect of smoking. In this sensitivity analysis, the SIR remained significantly below 1 showing the robustness of our results. Furthermore, we used the same definitions as the French national annual survey of smoking categories (Santé Publique France Health Barometer)[14] that we used for reference to calculate the SIR. Finally, we investigated apart the association of daily smoking with COVID-19 separately in outpatients and inpatients, which provides relevant information in addition to previous studies. Our study has also several limitations. First, the study was performed in early 2020 and the reference smoking rate in France were estimated from January to June 2019, as French smoking rates in 2020 are not available yet. However, it is very unlikely that a dramatic decrease in tobacco use may have occurred in France since mid 2019, which could explain our results. Actually, from 2017 to 2019, the daily smokers rate has decreased in France from 26.9% to 24.0%. The SIRs were estimated with the assumption that the studied population who lives in a limited area around a Parisian hospital has the same smoking habi...

    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.
    • Thank you for including a protocol registration statement.

    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.

  3. ScreenIT

    SciScore for 10.1101/2020.06.10.20127514: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementThe study has been approved by the ethics committee of Sorbonne University (2020 -Randomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variableResults: The inpatient group was composed of 340 patients, median age 66 years: 203 men (59.7%) an 137 women (40.3%), median age for both 66 years, with a daily smokers rate of 4.1 % CI95% [2.3–6. (5.4% of men, 2.2% of women).

    Table 2: Resources

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

    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 is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.06.10.20127514v1 on medRxiv