SynthesisNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2020
Smoking Is Associated With COVID-19 Progression: A Meta-analysis.
Synthesis in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04409496 (Chat-based Instant Messaging Support for Preventing Smoking Relapse in the Context of COVID-19 Outbreak), which is not on this map. Cited by 430 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Chat-based Instant Messaging Support for Preventing Smoking Relapse in the Context of COVID-19 Outbreak: a Pilot Randomised Clinical Trial
Who cites it
430 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Prevalence of systemic complications of COVID-19 in critically ill patients: systematic review with meta-analysis.Revista latino-americana de enfermagem · 2025Pooled it
- The role of smoking in COVID-19 progression: a comprehensive meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Hypertension and mortality in SARS-COV-2 infection: A meta-analysis of observational studies after 2 years of pandemic.European journal of internal medicine · 2023Pooled it
- Effects of the pre-existing coronary heart disease on the prognosis of COVID-19 patients: A systematic review and meta-analysis.PloS one · 2023Pooled it
- Outcomes associated with different vaccines in individuals with bipolar disorder and impact on the current COVID-19 pandemic- a systematic review.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2022Pooled it
- The Impact of the COVID-19 Pandemic on Smoking Consumption: A Systematic Review of Longitudinal Studies.Frontiers in psychiatry · 2022Pooled it
- Association of substance use with outcomes in mildly ill COVID-19 outpatients.The American journal of emergency medicine · 2023Trial
- Examining reactions to smoking and COVID-19 risk messages: An experimental study with people who smoke.The International journal on drug policy · 2022Trial
- Strengthening Tobacco Control during the COVID-19 Pandemic in India: A Secondary Policy Review and Analysis.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2026Review
- Sex differences in excess mortality during the COVID-19 pandemic: a longitudinal ecological analysis of 34 high-income countries.EClinicalMedicine · 2026Article
- Nicotine-Inspired, De Novo-Designed SARS-CoV-2 Main Protease Inhibitors Reveal Unique Chemistry for Covalently Conjugating Both Cysteine and Histidine Residues in the Catalytic Dyad.Journal of the American Chemical Society · 2026Article
- Unraveling the Enigma of COVID-19 pneumonia and lung diameters: An HR-CT based study.Pakistan journal of medical sciences · 2026Article
- From nicotine to SARS-CoV-2 antivirals with potent in vivo efficacy and a broad anti-coronavirus spectrum.Nature communications · 2026Article
- Association Between SARS-CoV-2-Related Experiences and Smoking Cessation in Switzerland: A Repeated Cross-Sectional Study.International journal of environmental research and public health · 2026Article
- Parents' Cigarette Purchases During COVID-19: Evidence From NielsenIQ Consumer Panel Data.American journal of preventive medicine · 2026Article
- COVID-19 outcomes in patients with inflammatory rheumatic diseases: associations with disease subtypes, treatments, and vaccination status.Frontiers in public health · 2026Observational
- Article
- Racism, discrimination, and distress: A cross-sectional examination of smoking behaviors among adults who smoke during the COVID-19 pandemic.Tobacco prevention & cessation · 2026Article
- Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of adults in the PATH Study in 2017-2019 vs 2019-2021.Tobacco control · 2025Article
- Relationship between lifestyle: physical activity, diet, smoking, and the duration of symptoms of SARS-CoV-2 virus infection.BMC infectious diseases · 2025Article
370 more citing papers are in PubMed but not listed here.
Corrections and comments
- Update of
Authors and funding
2 authors.
Funding
Abstract
introductionSmoking depresses pulmonary immune function and is a risk factor contracting other infectious diseases and more serious outcomes among people who become infected. This paper presents a meta-analysis of the association between smoking and progression of the infectious disease COVID-19.
methodsPubMed was searched on April 28, 2020, with search terms "smoking", "smoker*", "characteristics", "risk factors", "outcomes", and "COVID-19", "COVID", "coronavirus", "sar cov-2", "sar cov 2". Studies reporting smoking behavior of COVID-19 patients and progression of disease were selected for the final analysis. The study outcome was progression of COVID-19 among people who already had the disease. A random effects meta-analysis was applied.
resultsWe identified 19 peer-reviewed papers with a total of 11,590 COVID-19 patients, 2,133 (18.4%) with severe disease and 731 (6.3%) with a history of smoking. A total of 218 patients with a history of smoking (29.8%) experienced disease progression, compared with 17.6% of non-smoking patients. The meta-analysis showed a significant association between smoking and progression of COVID-19 (OR 1.91, 95% confidence interval [CI] 1.42-2.59, p = 0.001). Limitations in the 19 papers suggest that the actual risk of smoking may be higher.
conclusionsSmoking is a risk factor for progression of COVID-19, with smokers having higher odds of COVID-19 progression than never smokers. IMPLICATIONS: Physicians and public health professionals should collect data on smoking as part of clinical management and add smoking cessation to the list of practices to blunt the COVID-19 pandemic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.