ArticleClinical epidemiology2021
Smoking and COVID-19 Infection and Related Mortality: A Prospective Cohort Analysis of UK Biobank Data.
Article in Clinical epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Risk factors for SARS-CoV-2 infection during the early stages of the COVID-19 pandemic: a systematic literature review.Frontiers in public health · 2023Pooled it
- Nicotine dependence among critically ill COVID-19 patients: A population-based cohort study.PloS one · 2026Article
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- Risk of death due to COVID-19 among current and former smokers in the Netherlands: a population-based quasi-cohort study.International journal of epidemiology · 2024Article
- The impact of the COVID-19 pandemic on alcohol and tobacco consumption: Evidence from Peru.Social science & medicine (1982) · 2023Article
- Homozygous-Recessive Characteristics as a Biomarker of Predisposition for COVID-19.Clinical nursing research · 2023Article
- Differences in Clinical Outcomes between Smokers and Non-Smokers infected with COVID-19.Archives of Razi Institute · 2022Article
- DISCOVID: discovering patterns of COVID-19 infection from recovered patients: a case study in Saudi Arabia.International journal of information technology : an official journal of Bharati Vidyapeeth's Institute of Computer Applications and Management · 2022Article
- Smoking status related to Covid-19 mortality and disease severity in a veteran population.Respiratory medicine · 2021Article
- Predictors of severe COVID-19 in a registry-based Swedish cohort of patients with COPD.The European respiratory journal · 2021Article
- Social Capital and COVID-19 Deaths: An Ecological Analysis in Japan.International journal of environmental research and public health · 2021Article
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Authors and funding
4 authors.
Funding
Abstract
backgroundSeveral papers have shown contradictory evidence about the relationship between smoking and COVID-19-related deaths. There is little evidence about smoking and risk of infection. We aim to examine association between smoking and COVID-19 infection and subsequent mortality.
methodsThis was a prospective study with participants from the UK Biobank cohort. Participants who lived in England were followed up from 01/02/2020 to 28/06/2020 with data linked to hospital episode statistics, Office for National Statistics and Public Health England PCR tests. We compared current-smokers, previous-smokers with never-smokers and estimated risk ratio (RR) of COVID-19 infection and subsequent mortality using Poisson regression adjusting for age, sex, ethnicity, body mass index and socio-economic status. Interactions between smoking status and age and sex were tested for using multiplicative interactions, and analyses were stratified by median age (49-68 years, 69-86 years) and sex.
resultsIn total, 402,978 participants were included in the analyses. The majority were never smokers, 226,294 (56.2%), 140,090 (34.8%) were previous smokers, and 39,974 (9.9%) current smokers. COVID-19 infection was identified in 1591 (0.39%) people, and 372/1591 (23.4%) died. Amongst the younger participants, smokers were nearly twice as likely to become infected with COVID-19 than never smokers (RR 1.88 [1.49-2.38]) whereas there was no difference for those aged 69+ (RR 1.05 [0.82-1.34]). In contrast, amongst the older participants, smokers were twice as likely to die from COVID-19 compared to non-smokers (RR 2.15 [1.11-4.16]) whereas there was no difference for those under the age of 69 (RR 1.22[0.83-1.79]). Similar patterns were observed for previous smokers. The impact of smoking was similar in men and women.
conclusionThe association between smoking and COVID-19 infection and subsequent death is modified by age. Smokers and previous smokers aged under 69 were at higher risk of COVID-19 infection, suggesting the risk is associated with increased exposure to SARS-COV-2 virus. Once infected, older smokers were twice as likely to die from COVID-19 than never smokers, possibly mediated by increased risk of chronic conditions/illnesses.
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