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ASSOCIATION OF SMOKING AND SEVERITY OF COVID-19 INFECTION AMONG 5,889 PATIENTS IN MALAYSIA: A MULTI-CENTER OBSERVATIONAL STUDY

Ismail N 1 , Hassan N 2 , Abd Hamid MHN 3 , Yusoff UN 3 , Khamal NR 3 , Omar MA 4 Show all authors , Wong XC 5 , Pathmanathan MD 5 , Mohd Zin S 6 , Muhammad Zin F 6 , Nik Mohamed MH 7 , Mohd Nor N 8

Affiliations 

  • 1 Disease Control Division, Ministry of Health, Malaysia. Electronic address: norliana.ismail@moh.gov.my
  • 2 Disease Control Division, Ministry of Health, Malaysia. Electronic address: noraryana@moh.gov.my
  • 3 Disease Control Division, Ministry of Health, Malaysia
  • 4 National Institute of Health, Ministry of Health, Malaysia
  • 5 Digital Health Research and Innovation Unit, Institute for Clinical Research, Malaysia
  • 6 Medical Division, Ministry of Health, Malaysia
  • 7 Kulliyyah of Pharmacy, International Islamic University of Malaysia (Chairman of Technical Working Group World Health Organization Framework Convention on Tobacco Control Malaysia)
  • 8 Faculty of Economy, University Putra Malaysia (Vice Chairman of Technical Working Group World Health Organization Framework Convention on Tobacco Control Malaysia)
Int J Infect Dis, 2022 Mar;116:189-196.
PMID: 35021062 DOI: 10.1016/j.ijid.2022.01.011

Abstract

OBJECTIVE: This study aims to investigate the association between smoking and the severity of COVID-19 infection during the initial wave of this pandemic in Malaysia.

METHODS: This is a multi-center observational study using secondary hospital data collected retrospectively from February 1, 2020, until May 30, 2020. Clinical records of all real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 cases with smoking status, co-morbidities, clinical features, and disease management were retrieved. Severity was assessed by the presence of complications and outcomes of COVID-19 infection. Logistic regression was used to determine the association between COVID-19 disease severity and smoking status.

RESULTS: A total of 5,889 COVID-19 cases were included in the analysis. Ever smokers had a higher risk of having COVID-19 complications, such as acute respiratory distress syndrome (odds ratio [OR] 1.69; 95% confidence interval [CI] 1.09-2.55), renal injury (OR 1.55; 95% CI 1.10-2.14), and acute liver injury (OR 1.33; 95% CI 1.01-1.74), compared with never smokers. However, in terms of disease outcomes, there were no differences between the two groups.

CONCLUSION: Although no significant association was found in terms of disease outcomes, smoking is associated with a higher risk of having complications owing to COVID-19 infection.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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