Observational studyNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2022
Smoking Status and Factors associated with COVID-19 In-Hospital Mortality among US Veterans.
Observational study in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Article
- Nicotine dependence among critically ill COVID-19 patients: A population-based cohort study.PloS one · 2026Article
- Associations between public health measures and mortality among hospitalised COVID-19 patients: a cross-sectional study in Malaysia.Scientific reports · 2025Article
- Cigarette smoking status and COVID-19 hospitalization in the context of cannabis use: An electronic health record cohort study in northern California.Addictive behaviors reports · 2024Article
- The Saga of COVID-19 in Chronic Lung Disease: History Repeats Itself.Annals of the American Thoracic Society · 2024Article
- Effects of COVID-19 on Sleep Services Use and Its Recovery.Nature and science of sleep · 2024Article
- Does misclassification of former tobacco smokers explain the 'smoker's paradox' in the risk of COVID-19? Insights from the Stockholm Public Health Cohort.Scandinavian journal of public health · 2023Article
- The association between risk perceptions, anxiety, and self-reported changes in tobacco and nicotine product use due to COVID-19 in May-June 2020 in Israel.BMC public health · 2023Article
- Developing a Parsimonious Frailty Index for Older, Multimorbid Adults With Heart Failure Using Machine Learning.The American journal of cardiology · 2023Article
- Inflammatory Biomarkers Differ among Hospitalized Veterans Infected with Alpha, Delta, and Omicron SARS-CoV-2 Variants.International journal of environmental research and public health · 2023Article
- Assessing Smoking Status and Risk of SARS-CoV-2 Infection: A Machine Learning Approach among Veterans.Healthcare (Basel, Switzerland) · 2022Article
- The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2.International journal of environmental research and public health · 2021Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
introductionThe role of smoking in risk of death among patients with COVID-19 remains unclear. We examined the association between in-hospital mortality from COVID-19 and smoking status and other factors in the United States Veterans Health Administration (VHA).
methodsThis is an observational, retrospective cohort study using the VHA COVID-19 shared data resources for February 1 to September 11, 2020. Veterans admitted to the hospital who tested positive for SARS-CoV-2 and hospitalized by VHA were grouped into Never (as reference, NS), Former (FS), and Current smokers (CS). The main outcome was in-hospital mortality. Control factors were the most important variables (among all available) determined through a cascade of machine learning. We reported adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) from logistic regression models, imputing missing smoking status in our primary analysis.
resultsOut of 8 667 996 VHA enrollees, 505 143 were tested for SARS-CoV-2 (NS = 191 143; FS = 240 336; CS = 117 706; Unknown = 45 533). The aOR of in-hospital mortality was 1.16 (95%CI 1.01, 1.32) for FS vs. NS and 0.97 (95%CI 0.78, 1.22; p > .05) for CS vs. NS with imputed smoking status. Among other factors, famotidine and nonsteroidal anti-inflammatory drugs (NSAID) use before hospitalization were associated with lower risk while diabetes with complications, kidney disease, obesity, and advanced age were associated with higher risk of in-hospital mortality.
conclusionsIn patients admitted to the hospital with SARS-CoV-2 infection, our data demonstrate that FS are at higher risk of in-hospital mortality than NS. However, this pattern was not seen among CS highlighting the need for more granular analysis with high-quality smoking status data to further clarify our understanding of smoking risk and COVID-19-related mortality. Presence of comorbidities and advanced age were also associated with increased risk of in-hospital mortality. IMPLICATIONS: Veterans who were former smokers were at higher risk of in-hospital mortality compared to never smokers. Current smokers and never smokers were at similar risk of in-hospital mortality. The use of famotidine and nonsteroidal anti-inflammatory drugs (NSAIDs) before hospitalization were associated with lower risk while uncontrolled diabetes mellitus, advanced age, kidney disease, and obesity were associated with higher risk of in-hospital mortality.
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